AFFIDAVIT OF NO COMPLAINT

I, ___________________________, Filipino, of legal age, with postal address at Barangay

_________, ________ Municipality after having been duly sworn to in accordance with law hereby depose
and say that:
1. I am the Barangay Captain of Barangay _______ where the proposed ___________ will be located;

2. On __________ 2019, the ______ had informed the local government of Barangay about its
proposed Project and the status of their online application for Environmental Compliance Certificate
(ECC) with the Environmental Management Bureau of the Department of Environment and Natural
Resources (EMB-DENR);

3. We understood the associated impacts and benefits of the proposed ________________;

4. At the time when this Affidavit of No Complaint is being issued, there were no existing complaints
about this project that have been logged in out Barangay and we have not received any complaint
whatsoever from the residents of Barangay ______ that the proposed Project of ___________ will
be located, and;

5. I execute this affidavit to attest to the fact that Barangay __________ has not received any
complaint about the proposed __________ of ___________.

IN WITNESS WHEREOF, I have affixed my signature this ___ day of __________ 2019 at
___________________________.

_________________________
Affiant

SUBSCRIBED AND SWORN TO before me, this ___ day of ____________ 2019, affiant exhibited
to me the following Competent Evidence of Identity:

Name Competent Evidence of Identity Date/Place Issued

Passport ID No. _______________

Doc. No. ________;

Page No. ________;
Book No. ________;
Series of 2019