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Affidavit I, SYREL A. CALLOSA, of Legal Age, Filipino, Single With Residence and

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REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF PALO
) S.S
PROVINCE OF LEYTE
)
x---------------------------------------x
AFFIDAVIT
I, SYREL A. CALLOSA, of legal age, Filipino, single with residence and
postal address at Brgy. Pawing, Palo, Leyte, after having been duly sworn to in
accordance with law, depose and state THAT:
1. I was the Sangguniang Kabataan (SK) Chairman of Brgy. Pawing Palo,
Leyte for three (3) years starting on December 1, 2010 until November 30,
2013;
2. During the aforementioned tenure I have not been employed in the
government service neither did I receive any form of salary/compensation
for the said term/tenure;
3. I am executing this sworn declaration to confirm the truth of the
foregoing statements AND in support of my application for Grant of
Eligibility pursuant to R.A. 7160 (Barangay Official).
IN WITNESS WHEREOF, I have hereunto set my hand this 28th day of
July 2014 at the Municipality of Palo, Leyte, Philippines.

SYREL A. CALLOSA
Affiant
Student ID No. 1100130
Issued by Leyte Normal University
Valid until 2016

SUBSCRIBED AND SWORN TO before me a Notary Public in the


Municipality of Palo, Leyte this 28th day of July 2014, affiant exhibited her
identification card shown above.
Doc No. _____
Page No. ____
Book No. ____
Series of 2014
REPUBLIC OF THE PHILIPPINES)
MUNICIPALITY OF PALO
) S.S
PROVINCE OF LEYTE
)
x---------------------------------------x
AFFIDAVIT
I, SYREL A. CALLOSA, of legal age, Filipino, single with residence and
postal address at Brgy. Pawing, Palo, Leyte, after having been duly sworn to in
accordance with law, depose and state THAT:
1. I was the Sangguniang Kabataan (SK) Chairman of Brgy. Pawing Palo,
Leyte for three (3) years starting on December 1, 2010 until November 30,
2013;
2. I am not related up to the 4th degree of consanguinity or affinity to the
appointing punong barangay;
3. I am executing this sworn declaration to confirm the truth of the
foregoing statements AND in support of my application for Grant of
Eligibility pursuant to R.A. 7160 (Barangay Official).
IN WITNESS WHEREOF, I have hereunto set my hand this 28th day of
July 2014 at the Municipality of Palo, Leyte, Philippines.

SYREL A. CALLOSA
Affiant
Student ID No. 1100130

Issued by Leyte Normal University


Valid until 2016

SUBSCRIBED AND SWORN TO before me a Notary Public in the


Municipality of Palo, Leyte this 28th day of July 2014, affiant exhibited her
identification card shown above.
Doc No. _____
Page No. ____
Book No. ____
Series of 2014

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