Republic of the Philippines )
City of ______
AFFIDAVIT OF INDIGENCY
I, _________________, of legal age, single/married/widow, Filipino citizen, and presently residing at _____________________, after having been duly sworn to in accordance with law, do hereby depose and say:
1. That I desire to avail of the free legal service of the Public Attorney’s Office.
2. That my monthly net salary/income is P____________.
3. That I am executing this affidavit to entitle me to the desired legal services.
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _____________ at ______________, Philippines.
SUBSCRIBED AND SWORN to before me this ____ day of ___________ in _________, Philippines, and I have read and translated the foregoing Affidavit in a dialect known and understood by him/her..
Doc No. : _____
Page No.: ______
Book No.: ______Series of 2014 Public Attorney II