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Sample-Affidavit (Non-Filing of Income Tax Return

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Republic of the Philippines )

City/Municipality of___________) S.S


X ---------------------------------------------- X

AFFIDAVIT
(Re: Non-Filing of Income Tax Return)

I, ________________________, of legal age, married/single, Filipino


and with residence address at __________________________, after having
been sworn to in accordance with law do hereby deposes and says:

1. That I am the legitimate FATHER / MOTHER / GUARDIAN of


_________________________________________, a student of
_________________________________________ (school).

2. That one of the requirements of his/her application for


_________________________, that he/she had been required to submit is
the latest Income Tax Return of her parents or guardians.

3. That I am _____________________________ (occupation) and


my spouse is a ________________________ (occupation), with no fix
income. That I and my spouse did not file an Income Tax Return with the BIR
Office on the belief that we are exempted from filing from such requirement with
our meager monthly income.

4. That I am executing this affidavit to attest to the foregoing narration of


facts and for whatever legal purposes and intents this may serve.

IN TESTIMONY WHEREOF, I have hereunto affixed my signature this


____ day of ________________at ____________________, Philippines.

________________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE me this _______ of


_________________ at ______________________, Philippines. Affiant
exhibited his/her Community Tax Certificate bearing No. ________________
issued on _______________ at _______________________, Philippines.

_____________________________
PUBLIC ATTORNEY ____
(Pursuant to R.A. 9406)

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