REPUBLIC OF THE PHILIPPINES)
_______________________________ )
AFFIDAVIT OF DEPENDENCY
I, ____________________, Filipino, of legal age, single, with address at
________________________, after having been duly sworn in accordance with law, hereby depose and
state that:
1. I am the ________________________, Filipino, of legal age, and born on _______________
to our parents ______________________;
2. Our father is unemployed, while our mother has no fixed income, being a mere contractual
nurse in ___________________. As such, my brother is fully dependent on me for care and financial
support;
3. I am financially capable to support my brother, being a regular employee of Nestle Business
Services and with stable income;
4. I am executing this Affidavit not for remuneration whatsoever, but to attest to the truth of the
foregoing facts and for whatever legal purposes this may serve.
IN WITNESS WHEREOF, I have hereunto set my hands this ______ day of ________________
in ____________________________.
____________________________
Affiant
SUBSCRIBED AND SWORN to before me this ____________________. Affiant exhibited to me
her Professional Identification Card No. _____________________ as evidence of her identity and that
she is the same person who personally signed before me the foregoing affidavit and acknowledged that
she executed the same.
.