Republic of the Philippines )

Province of Camarines Sur ) SS.

Municipality of Goa )

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AFFIDAVIT OF LOW INCOME

We, Spouses DONGDONG A. DANTES and MARIAN B. RIBERA, both of legal age, Filipino citizens and residents of Brgy. Gimaga, Goa, Camarines Sur, Philippines, after having been duly sworn to in accordance with law hereby depose and state THAT:

1. We are the legitimate parents of DINGDING R. DANTES, a high school graduate who is applying for a CHED Scholarship Program;

2. As seasonal farmer and housekeeper, respectively, we are low income earners;

3. Our annual income of FIFTY FIVE THOUSAND PESOS (P55,000.00) is so meager and only enough to cover our daily needs;

4. We executed this affidavit to attest to the veracity of the above and in support to our son's application for a scholarship program.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

SUBSCRIBED AND SWORN to before me, this ____ day of __________ 20____, in the City of __________________, by ___________________ with Passport No.________________ issued on __________________ at _____________.

Notary Public

Doc. No. ______;

Page No. ______;

Book No. ______;

Series of ______;