Republic of the Philippines )

Province of Palawan

) S.S

Municipality of Taytay

)
AFFIDAVIT OF SOURCE OF INCOME

I, DARLIN JOY BUSAING ALBAY, Filipino, of legal age, single and a resident of
So. Binuan, Libertad, Taytay, Palawan, after having duly sworn in accordance with law
hereby depose and state that:
1.

That I am earning money by being a market vendor in Sitio Binuan, Taytay,

Palawan since 2005;

2. That being market vendor is the primary source of my income;
3. That my monthly income ranges from 2,500 pesos to 5,000 pesos;
4. That I am executing this Affidavit to attest to the truth of the foregoing facts
and to support the justification of my application as Self-Employed member of
SSS.
IN WITNESS WHEREOF, I have hereunto set my hand this 19 th day of
September 2016 in Taytay, Palawan, Philippines.

DARLIN JOY BUSAING ALBAY

Affiant
VIN 5320-0076A-B0695DBA20000-2
SUBSCRIBED AND SWORN TO before me this 19 th day of September 2016 in
Taytay, Palawan, Affiant exhibited to me her Voters Certification as shown below her
name and signature.

Doc. No.______;
Page No._____;
Book No.______;
Series of 2016