REPUBLIC OF THE PHILIPPINES )
PROVINCE OF TARLAC ) S.S.
MUNICIPALITY OF PANIQUI )
AFFIDAVIT OF GUARDIANSHIP
I, EUFEMIA CARDONA EUGENIO, of legal age, Filipino, married with postal
address at Melecio Manganaan, Mayantoc, Tarlac, after having been duly sworn to according to
law hereby depose and state:
1. That I am the grandmother of DIANELLE PALAROAN EUGENIO, who
was born on January 15, 2002 at San Juan, La Union, daughter of Spouses
Elmer Eugenio and Lita Palaroan;
2. That the said ward is under my guardianship and custody since her mother
work abroad;
3. That since then up to now, I stand as her guardian and almost a parent to her;
4. That I am not employed in any company or business institution;
5. That my family depend only on the income we earned in our farm to support
our daily living, thus, I cannot support my granddaughter’s highest education;
6. That I have executed this affidavit to attest to the truth of the foregoing
statements and to urge the Bureau of Internal Revenue to issue in my favor a
Certificate of Non-Filing for Scholarship/summer job purposes of my
granddaughter named, DIANELLE PALAROAN EUGENIO.
7. That should the foregoing information given by me were found to be false
upon verifications, I shall be liable for whatever penalties provided in the Tax
Code in addition to perjury.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hands this 2 nd day of February, 2018,
at Paniqui, Tarlac.
EUFEMIA CARDONA EUGENIO
Affiant
SUBSCRIBED and sworn to before me, in the Municipality of Paniqui, Province of
Tarlac this 2nd day of February, 2018, by Eufemia Cardona Eugenio, personally known to me and
who in person signed before me the foregoing affidavit.
Doc. No. _______;
Page No. _______;
Book No._______;
Series of 2018