REPUBLIC OF THE PHILIPPINES )

BATANGAS CITY )S.S.

AFFIDAVIT

I, ADELAIDA A. LONTOC, of legal age, married, Filipino, and a resident of Ma.

Christina Heights, Kumintang Ibaba, Batangas City after having been sworn to in
accordance with law, hereby depose and say, that:

[1] I am the owner of Adeling Pharmacy located at Bago Public Matket, Batangas
City;

[2] The said business is registered with the Social Security System (SSS) employer
with SSS Employer Number 04-0961317-9

[3] In the period of July 2010 to March 2011, I didn’t have an employee and the
said business was operated by me;

[4] REMEDIOS R. UNTALAN with SSS No. 04-0824577-1 and ERLINDA C.

GUALBERTO with SSS No. 04-1194609-6 were employed in the said business on April
2011 up to present;

[5] I am executing this affidavit to attest to the truth of the foregoing facts and to
notify the proper authorities for whatever legal intent and purpose it may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this __________________

at Batangas City.

ADELAIDA A. LONTOC
Affiant
SSS ID. No. 04-0368445-0

SUBSCRIBED AND SWORN to before me this ___________________ at Batangas

City, affiant exhibiting to me her competent evidence of identity as first above stated.