Republic of the Philippines

Tuguegarao City
) S.S.
AFFIDAVIT OF NON-PENDENCY OF ADMINISTRATIVE/ CRIMINAL CASE
I, VALERIANO JESUS V. LOPEZ, MD, MPH, MHA, CESO IV , of
legal age, Filipino, with permanent address at
# 20 P. Rivera Street, TS
Cruz Subdivision, Novaliches Quezon City, after having been duly sworn to in
accordance with law, hereby voluntarily depose and say:
1.

That I am currently employed as Regional Director of the

Department of Health Regional Office II;

2.

That I am applying for a change of rank from CESO IV to CESO

III;

3. That I have not been charged with any act or omission punishable
by law, rule or regulation before a prosecutor, judge, public officer
or administrative body of any crime or offense involving moral
turpitude; nor has he any pending case or charge filed before the
Department of Health;
4. That I am executing this affidavit to attest to the truth of the
foregoing facts for the expeditious processing of my application for
change in rank as Career Executive Service Officer.
IN WITNESS HEREOF, I have set my hand and affixed my signature
this 22nd day of October, 2015 at Tuguegarao City.

VALERIANO JESUS V. LOPEZ, MD, MPH, MHA,

CESO IV
(Affiant)

SUBSCRIBED AND SWORN TO BEFORE ME this 20th day of

October, 2015, affiant exhibited to me his DOH Office ID with No.
2200150002 issued at Tuguegarao City on May 18 2015.
.

NOTARY PUBLIC
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