REPUBLIC OF THE PHILIPPINES )
CITY OF QUEZON             ) s.s
      x----------------------x
                                      AFFIDAVIT OF DISCLOSURE
      I ________________________________, Filipino of legal age, married and a resident of
      __________________________________________, after having been duly sworn to in
      accordance with law, hereby depose and say:
      1. That I am an applicant for a certificate of registration with the Department of Labor and
      Employment to operate as job/service contractor/subcontractor under the business name
      __________________________________________, with business address at
      ___________________________________________ and duly registered with the Department of
      Trade and Industry/Securities and Exchange Commission.
       2. That said _______________________________________________________ is not a
      "Labor-only" contractor and/or agency as defined under Article 106 of the Labor Code of the
      Philippines since it has capital or investment in the form of tools, equipment or machinery and
      the workers placed therein are not performing activities which are directly related to the main
      business of its principal or client.
       3. That said _____________________________________________________ will undertake
      and/or provide services, works or jobs as it may contract from individuals, companies, or other
      entities, public or private and will abide with all applicable labor laws, rules and regulations.
       4. Sworn disclosure that the registrant, its Officers and Owners or principal stockholders have
      not been operating or previously operating as a contractor under different business name or
      entity; the list of clients, if any, the number of personnel assigned to each client, if any, and the
      services provided to the client.
      5. That I am executing this affidavit to attest to the truth of the foregoing facts.
      IN WITNESS WHEREOF, I have hereunto set my hand this ___________ day of
      __________________, 20______ in the City of ______________________, Philippines.
                                                                              _____________________
                                                                                        Affiant
                                                              CTC No.__________________________
                                                              Issued at __________________________
                                                              Issuedon __________________________
        SUBSCRIBED AND SWORN to before me this _______ day of _____________ 20______ in
the City of _________________________, Philippines.