REPUBLIC OF THE PHILIPPINES

PROVINCE OF TARLAC
MUNICIPALITY OF CAMILING

)
) S.S.
)

AFFIDAVIT
I, LETICIA L. IBALE, 64 years old, married, Filipino citizen and a resident
of Barangay Sinilian Cacalibosuan, Camiling, Tarlac, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state THAT:
1. I became a self-employed member of the Social Security System as I was
then engaged in hog raising farming;
2. However, starting January 1, 2015, due to health reasons and old age, I
ceased to work as a hog raising farmer and did not engage in any gainful
occupation up to present;
3. I am executing this Affidavit in support of my Retirement Claim from the SSS;

4. Finally, I am executing this Affidavit to attest to the truth of the foregoing

statements and for all legal intents and purposes it may serve .
IN WITNESS WHEREOF, I have hereunto affixed my signature this 28th
day of April, 2015 at Camiling, Tarlac, Philippines.
LETICIA L. IBALE
Affiant
SUBSCRIBED AND SWORN to before me on the date and place indicated
above. Affiant exhibited before me her Senior Citizen Card with Control No.
03223 issued by the OSCA Camiling, Tarlac.