REPUBLIC OF THE PHILIPPINES)

CITY OF MANILA ) S.S.

SWORN STATEMENT

I, ______________________, of legal age, Filipino, married and with office

address at _______________________________ after having been duly sworn in
accordance with law, hereby depose and state:

1. I have a meaningful participation in internal quality review process;

2. I have undergone adequate and effective training (from organization duly
accredited by the Board or by its duly authorized representatives) on all the
current accounting and auditing standards, code of ethics, laws and their
implementing rules and regulations, circulars, memoranda, their respective
codes of good governance and other related documents that are required in
the practice of public accountancy to ensure professional, ethical and
technical standards;
3. I am of good moral character.
4. I have not been found guilty by competent court and/or administrative body of
any case involving moral turpitude and/or unethical practices and that neither
any of them is a defendant in any case of similar nature pending before any
competent court and/or administrative agencies.
5. I have at least three (3) years meaningful experience in the scope of work
covered in accountancy practice (please see detailed description of work
experience);

That I, as single practitioner, I am executing this affidavit in support to may

application to practice public accountancy in the Philippines;

IN WITNESS WHEREOF, I have hereunto affixed my signature this day

of ______________, at ______________________, Philippines.

NAME & SIGNATURE

SUBSCRIBED AND SWORN to before me this ______ day of ________,

2014 at ______________, affiant exhibited to me her Community Tax Certificate
No. _____________ issued at City of _________on ___________, 2014.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 20 14