Affidavit No ITR

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Republic of the Philippines )

Municipality of Cateel ) S.S.


Province of Davao Oriental )
x-----------------------------x

AFFIDAVIT OF NON-FILING OF
INCOME TAX RETURN
I, MARIBEL M. MONGAYA, married to Jonie S. Mongaya, both
of legal age, Filipinos, and residents of Brgy. Poblacion, Municipality of
Cateel, Province of Davao Oriental, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state THAT:

1. I am currently applying for the issuance of Department of


Agriculture (DAR) Clearance.

2. One of the requirements for the issuance of the DAR Clearance


is a Certified True Copy of Income Tax Return from the Bureau
Internal Revenue (BIR).

3. Although I am already working as self-employed, however, I


am not gainfully employed in any private or government
agency nor I engage in any form of business or enterprise.

4. That I am executing this affidavit to attest to the veracity of


the foregoing facts, in support of my DAR Clearance
application and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand, this 17 th


day of April at Cateel, Davao Oriental, Philippines.

MARIBEL M. MONGAYA
Affiant
CEI: TIN 713-684-832

SUBSCRIBED AND SWORN to before me, this 17th day of April at


Cateel, Davao Oriental, Philippines, Affiant exhibited to me his
competent evidence of identity written below his name.

Doc. No.: ____;


Page No.: ____;
Book No.: ______;
Series of 2024.

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