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Republic of the Philippines )

City of Tagum . . . . . . . . . . . . . . . )S.S


X------------------------x

AFFIDAVIT OF DENIAL

I, MOHSIN Q. GALMAC, of legal age, Filipino, married and a resident


of Purok 3, Barangay Taba, Carmen, Davao del Norte, Philippines after
having been duly sworn to in accordance with law, depose and state:

1. That I am an employee of the Provincial Government of Davao Del


Norte duly assigned at Provincial Economic Enterprise Development
Office as Administrative Aide I;

2. That I would apply for a Multi-Purpose Loan (MPL) with Home


Development Mutual Fund (HDMF) also known as “PAG-IBIG Fund”;

3. That I received an information from the said office that I have an


outstanding balance of Six Thousand Nine Hundred Twelve Pesos and
Thirty Two Centavos (P6, 912.32.00) for a loan beginning 2016. A copy
of Borrower’s subsidiary Ledger is hereby attached as Annex “A”;

4. That I hereby unequivocally deny the acquisition of the said loan;

That I am executing this Affidavit to attest to the foregoing facts and


to deny absolutely and entirely any involvement in the aforementioned loan
and for all legal intents and purposes.

IN WITNESS WHEREOF, I hereby affixed my signature


this ___________________ in Tagum City, Davao del Norte, Philippines.

MOHSIN Q. GALMAC
Affiant

SUBCRIBED AND SWORN TO before me


this _____________ in Tagum City, Davao del
Norte Philippines, affiant exhibiting to me his competent evidence of identity
by way of Professional Driver’s License with ID. No. L06-15-004761 issued
at Tagum City.
Doc. No. _____;
Page No. _____;
Book No. _____;