Affidavit of Indigency

I, _____________of legal age, single/married to _____________________________and residing at  _______________ and having been duly sworn in accordance with law, 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 affixed my signature this ______________ day of ____, 20 _______, in the City/Municipality of _________ , Province of ___________.