Republic of the Philippines)
Province of ____ ) SS
Municipality of _________)
AFFIDAVIT OF ECONOMIC STATUS
I, DINA BIRHEN, married to WALEY P. KIALAM, of legal age,
Filipino, and with postal address at __________________________,
after having been sworn according to law, hereby depose and state:
THAT---
1. My son NAKKI KIALAM is interested to apply for the DOLE
SPES Summer Job Program in the Local Government Unit of
______________________;
2. I am a plain housewife and my husband being a self-employed
individual being a Tricycle Driver, without a fixed monthly
income;
3. My family’s average monthly income of P 9,000.00 is barely
enough for our daily needs considering that I have two (2)
dependent children;
4. I attest to the truth of the foregoing;
This affidavit is made for the purpose of securing a Certificate of
Tax Exemption from the Bureau of Internal Revenue (BIR) and for such
other legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this ____
day of March 2020 at _____________, Philippines.
DINA BIRHEN
Affiant
SUBSCRIBED AND SWORN to before me this ___ day March
2020 at _____________________, Philippines.
Doc. No. ____
Page No. ____
Book No. ____
SERIES OF 2018