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Republic of the Philippines

City of Davao ))S.S.


x-------------------------------------x

AFFIDAVIT

I, Li Pong, of legal age, Filipino, and a resident of Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and state that:

1. I am currently the President of something;

2. I took over the management of something some time in 2013;

3. Recently, the said Restaurant was assessed by the Social Security System (SSS)
for alleged underpayment of employer contributions covering among others,
the period from 1989 up to 1997;

4. Unfortunately, the records that could support our payments to the SSS as
employer contributions for the above-mentioned period could no longer be
found due to the lapse of considerable amount of time;

5. Diligent efforts made to locate the said records proved futile;

6. I am executing this affidavit to attest to the veracity of my statements to the


best of my own personal knowledge and for all lawful intents and purposes it
may serve;

IN WITNESS HEREOF, I have hereunto set my hand this 25th day of February
2016, in Gotham, Philippines.

Li Pong
Affiant
ID Type: _______
ID No.: _______

SUBSCRIBED AND SWORN to before me this 25th day of February 2016, in Davao City,
Philippines; Affiant exhibiting to me her competent evidence of identity as indicated above.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2016.

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