REPUBLIC OF THE PHILIPPINES ) CITY OF CEBU_____________) SS. SWORN AFFIDAVIT I, NILO BOTAY, of legal age, Filipino and a resident of __________________, Philippines, after being duly sworn to in accordance with law do hereby deposed and say: 1. That I am married to NILA ROTAY since____________. Copy of our marriage certificate herein attached as Annex “A” ; 2. That I was employed in the Armed Forces of the Philippines since__________________; 3. That I was stationed at_____________________for the period of _______until___________________. 4. That during the above-mentioned period I have been living separately from my wife and family for the reason that I was assigned in______________and my wife was left at our home in_______________to manage the household ; 5. That I executed this Sworn Affidavit to attest to the foregoing facts and circumstances and for whatever legal purpose this may serve. IN WITNESS WHEREOF, I have hereunto set my hand this ___________ at the _________________, Philippines. NILO BOTAY
Affiant Type of ID:_______________ ID No.: __________________ SUBSCRIBED AND SWORN to before me, this ___________ at the ______________________, Philippines, affiant exhibiting to me the competent evidence of identity indicated above. Doc No. ____: Page No. ___; Book No. ___; Series of 2015.