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Affidavit of No Work, No Pay Sample and Complete Guide | Free Template

Affidavit of No Work, No Pay: Meaning, Purpose, and Sample Form

An Affidavit of No Work, No Pay is a sworn statement issued by an employee declaring that they did not report for work on specific dates and therefore did not receive any salary or compensation for those days. This affidavit is usually required for payroll verification, loan processing, financial assistance programs, government requirements, or employment documentation purposes.

It serves as an official declaration confirming unpaid absences, ensuring that the employee’s attendance and salary records align with company or government data. Since this affidavit is executed under oath, all statements must be true to avoid penalties or administrative sanctions.

When Is an Affidavit of No Work, No Pay Needed?

This affidavit may be required in the following cases:

  • Application for financial aid or government benefits.
  • Verification of unpaid absences by employers.
  • Bank or loan applications requiring proof of reduced income.
  • Employment records correction or verification.
  • Submission for insurance or compensation claims.
  • Documentation required during emergencies, calamities, or lockdowns.

The affidavit may include specific dates of absence as well as reasons if requested by the institution.

What Should Be Included in an Affidavit of No Work, No Pay?

A complete affidavit should contain:

  • Employee’s full name, age, and address.
  • Name of employer or company.
  • Specific dates when no work was rendered.
  • Statement confirming no salary was received for those dates.
  • Purpose of issuing the affidavit.
  • Affirmation of truthfulness.
  • Affiant’s signature and notarization block.

Supporting documents such as attendance logs or payslips may also be requested.

Sample Affidavit of No Work, No Pay (Editable Template)

Below is an easy-to-edit affidavit template. Replace all bracketed fields with correct information before printing.

REPUBLIC OF THE PHILIPPINES
[CITY / MUNICIPALITY]
[PROVINCE]

AFFIDAVIT OF NO WORK, NO PAY

I, [FULL NAME OF EMPLOYEE], of legal age, [citizenship], [civil status], employed at [company name] and residing at [complete address], after being duly sworn in accordance with law, hereby depose and state:

1. That I am currently employed as [position] under [company name] located at [company address].

2. That I was not able to report for work on the following date(s): [list specific dates of absence].

3. That I declare under oath that I did not receive any salary, allowance, or compensation from my employer for the aforementioned date(s) as these were considered No Work, No Pay days.

4. That I am executing this Affidavit of No Work, No Pay to comply with the requirements of [agency/bank/company/local government] and for any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this [day] day of [month, year] at [place of execution].


_________________________________
[FULL NAME OF EMPLOYEE]
Affiant

SUBSCRIBED AND SWORN to before me this [day] day of [month, year] at [place], affiant presenting his/her government-issued ID as proof of identity:

ID Type and No.: [ID Type and Number]
Date & Place of Issuance: [details]


_________________________________
NOTARY PUBLIC
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of _____.

Disclaimer: This affidavit template is for general documentation purposes. Requirements vary depending on government agencies, banks, and employers. Consult legal or HR personnel if needed.

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