Republic of the Philippines-----------)

City of Butuan---------------------------) SS

AFFIDAVIT

I, JOHANN ERWIN B. BALDERAS, a CPA, of legal age, married, Filipino and a resident of
Butuan City, after being duly sworn in accordance with law, hereby depose of and say:

1. That pursuant to Section 244 of NIRC of 1997, as amended, all self-employed

professionals shall submit an affidavit indicating the rate, manner of billings and the
factors they consider in determining service fees upon registration and every year
thereafter on or before January 31;

2. That in every “Service Engagement” the mode of services my clients require is

emphasized and agreed upon, to wit:
a) General audit or short audit of an existing business proprietorship, the rate of
P10,000.00;
b) Consultation and preparation of document for new/renewal of application of
business, with DTI, BIR, City Government and Corporation to SEC rate of
P3,000.00;
c) Monthly retainer’s fee of P1,000.00 to P1,500.00;
d) Service fee for such as preparation of BIR forms and payment P4,000.00 to
P8,000.00;

3. That the billing is done every end of the month for retainer’s fee and billing for full
payment of other services at the end of the engagement;

4. THAT THIS SWORN AFFIDAVIT is executed in good faith as required by Revenue

Regulation No. 4-2014, dated March 3, 2014.

IN WITNESS WHEREOF, I have AFFIXED MY SIGNATURE, this 30th day of April, 2014 at
Butuan City, Agusan Del Norte.

JOHANN ERWIN B. BALDERAS

AFFIANT

SUBSCRIBED AND SWORN TO before me, this 30th day of April, 2014 at Butuan City,
Agusan del Norte. This AFFIANT exhibited his Community Tax Certificate No. 29708383 issued at
Butuan City, Agusan del Norte on February 6, 2014.

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Republic of the Philippines-----------)
City of Butuan---------------------------) SS

AFFIDAVIT

I, CRIS BERNARD S. ABREA, a Physician, of legal age, married, Filipino and a resident of
Butuan City, after being duly sworn in accordance with law, hereby depose of and say:

1. That pursuant to Section 244 of NIRC of 1997, as amended, all self-employed

professionals shall submit an affidavit indicating the rate, manner of billings and the
factors they consider in determining service fees upon registration and every year
thereafter on or before January 31;

2. That the professional fees for my services is 50% of surgeon fees to every patient.

3. That the billing is done by the surgeon and the share of the anesthesiologist will be
given by the surgeon or hospital after payment of the patient.

4. That the billing of the hospital will be forwarded to PHILHEALTH.

5. THAT THIS SWORN AFFIDAVIT is executed in good faith as required by Revenue

Regulation No. 4-2014, dated March 3, 2014.

IN WITNESS WHEREOF, I have AFFIXED MY SIGNATURE, this 30th day of April, 2014 at
Butuan City, Agusan Del Norte.

CRIS BERNARD S. ABREAN

AFFIANT

SUBSCRIBED AND SWORN TO before me, this 30th day of April, 2014 at Butuan City,
Agusan del Norte. This AFFIANT exhibited his Community Tax Certificate No. ___________
issued at Butuan City, Agusan del Norte on __________________.

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Book No.____
Series of 2014