legal forms project

Republic of the Philippines

Republic of the Philippines)

PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF CONSENT

I, PABLABIO P. AGAR of legal age, Filipino, married and a resident of Barangay District I, Poblacion, Burauen, Leyte, after being first sworn according to law, do hereby depose and state: THAT---

1. I am the father of SHANE N. AGAR, who was born on 16 MARCH 2000 in Burauen, Leyte.

2. I am giving my consent to my daughter SHANE N. AGAR to travel to Nagasaki, Japan for the Period JANUARY 5, 2015 to JUNE 30, 2016 for the Climate Change Youth Convention.

3. My daughter will be accompanied by MR. JOMBAL D. KING, Municipal Disaster Risk Reduction Management Officer in the duration of the travel in Japan.

4. I am executing this affidavit to attest to the truth of the facts aforecited and for the purpose of giving my consent for the travel of my daughter SHANE N. AGAR to Japan on JANUARY 5, 2015 to JUNE 30, 2016.

AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 25 April 2016 at Burauen, Leyte, Philippines. ____________________PABLABIO P. AGAR

Affiant

SUBSCRIBED AND SWORN to before me this 02 December 2015 at Burauen, Leyte, Philippines, and affiant exhibiting to me his COMELEC ID No. VIN 7010-0070A-G1571RBB20100 as competent evidence of identity.Doc. No. 22Page No.02Book No. XVV

SERIES OF 2016Republic of the Philippines)

PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF DESISTANCE

I, PABLABIO P. AGAR, of legal age, Filipino, married and a resident of Barangay District I, Burauen, Leyte, after being first sworn according to law, do hereby depose and state: THAT---

1. I am the complainant in the three (3) cases of Reckless Imprudence resulting to Damage to Property filed against SAMIL R. BADUYA before the Office of the Burauen, Leyte Prosecution Office on 1 December 2015.

2. For humanitarian consideration, I cannot proceed in the further prosecution of these cases and I hereby voluntarily consent to the dismissal of the complaints. As such, even if I am called to testify, I will no longer appear in court.

3. I therefore request the Honorable City Prosecution Office to drop, close and terminate the aforesaid cases against SAMIL R. BADUYA, and to order her release from detention in the Burauen PNP station lock up cell or Municipal Jail for reason aforestated.

IN WITNESS WHEREOF, I have hereunto set my hand this 1 December 2015 at Burauen, Leyte, Philippines.

____________________PABLABIO P. AGAR Affiant/Complainant

SUBSCRIBED AND SWORN to before me this 4 December 2015 at Burauen, Leyte, Philippines.

Doc. No. 23Page No.03Book No. XVV

SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF LEGITIMATION

We, PABLABIO P. AGAR and JANE Q. AGAR, both of legal age, Filipinos, married and residents of Barangay District I, Burauen, Leyte, after having been duly sworn to in accordance with law, do hereby deposes and say:

1. That we are the natural parents of MARY QUITON who was born on June 26, 1998 in Burauen, Leyte;

2. That during the birth of our daughter MARY, we were still not yet legally married so that said childs Certificate of Live Birth was registered using her mothers surname QUITON;

3. That we have contracted our marriage only last March 16, 2003 at Office of the Honorable Municipal Mayor JUAN R. BURAWON ,Burauen, Leyte, copy of which Certificate of Marriage issued by Municipal Civil Registrar is hereto attached to form part of this affidavit;

4. That my age at the time (Mary) that said child was born I was only 15 years old;

5. That we are executing this affidavit in order to change the status of our child Anabelle Banal as illegitimate to legitimated by virtue of our marriage and for him to use the surname AGAR.

IN WITNESS WHEREOF, we have hereunto set our hands this 4th day of December 2015 at Burauen, Leyte, Philippines.

__________________ ____________________ PABLABIO P. AGAR JANE Q. AGAR

Affiant Affiant

SUBSCRIBED AND SWORN to before me this 4th day of December 2015 at Burauen, Leyte, Leyte, Philippines.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF LOSS

I, PABLABIO P. AGAR, of legal age, Filipino, married and a resident of Barangay District I, Burauen, Leyte, after having been sworn to according to law, hereby depose and state: THAT

1. I am a holder of an expired Professional Drivers License No. H02-88-005673 issued by the Land Transportation Office in Tacloban City, Leyte.

2. Sometime on October 2015, I lost said drivers license while in transit from Burauen, Leyte to Tacloban City on a public utility bus.

3. I surmised that it must have fell off from said pocket while on board said bus; despite diligent effort to look for said vehicle and my drivers license which, I presumed, might have fell off in said vehicle, I could no longer recover it. The loss of said license did not bother me for the time being, since I did not find any need to drive a car.

4. Said drivers license was not confiscated for violation of traffic rules.

5. I am executing this affidavit to attest to the truth of the loss of said professional drivers license for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 04th day of December 2015 at Burauen, Leyte, Philippines.

__________________ PABLABIO P. AGAR

Affiant

SUBSCRIBED AND SWORN to before me this 04th day of December 2015 at Burauen, Leyte, by PABLABIO P. AGAR who has satisfactorily proven his identity to me through his CTC No. 5698756 issued on 2/28/15 in Tacloban, Leyte, that he is the same person who personally signed the foregoing affidavit before me and acknowledged that he executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xJOINT AFFIDAVIT OF PARENTS

AS TO SOURCE OF INCOME/LIVELIHOOD

We, PABLABIO P. AGAR and JANE Q. AGAR, both of legal age, spouses, Filipinos and with postal address at District 1, Poblacion, Burauen, Leyte, after having been sworn according to law, hereby depose and state: THAT---

Palabio is unemployed, while Jane works as cashier at Lindas Turo-turo, Burauen, Leyte;

This joint affidavit is executed in connection with the requirements for tax exemption certificate (for scholarship) of their daughter Mary Q. Agar at University of the Philippines, Tacloban (UP-Tac).

IN WITNESS WHEREOF, we have hereunto set our hands this 4 December 2015 at Burauen, Leyte, Philippines.

__________________ ____________________ PABLABIO P. AGAR JANE Q. AGAR

SUBSCRIBED AND SWORN to before me this 4 December 2015 at Burauen, Leyte, by PABLABIO P. AGAR and JANE Q. AGAR, personally known to me, who are the same persons who personally signed before me the foregoing Joint Affidavit of Parents as to source of income/livelihood, and acknowledged that they executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xJOINT AFFIDAVIT OF COHABITATION

We, ROY YU TAN and MAY AGAR SY, both of legal age, single, Filipino, and residents of Barangay District I, Burauen, Leyte, after having been duly sworn to in accordance with law hereby depose and state: THAT-1. 1. We, ROY YU TAN and MAY AGAR SY, have been cohabiting as husband and wife since the year 2005 or for more than ten years, having taken up the same residence in Barangay District I, Burauen, Leyte;

2. 2. Since the beginning of our cohabitation until the present, we possess all the qualifications and none of the disqualifications to contract a valid marriage;

3. 3. On December 01, 2015, we were married at Sto. Nino church and our marriage was solemnized by Rev. Msgr. Jake Mazo, the Parish Priest;

4. 4. In accordance with Art. 34 of the Family Code, our marriage was solemnized without the need of a marriage license, having lived together as husband and wife for more than ten years;

5. 5. We are executing this affidavit to attest to the truth of the foregoing statements, for the late registration of our Marriage Certificate and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this 01st day of December, 2015 at Burauen, Leyte, Leyte, Philippines. _________________________

_______________________ ROY YU TAN

MAY AGAR SY Affiant

Affiant

ID No. MH-02356 ID No. CL00256SUBSCRIBED AND SWORN to before me this 04th day of December, 2015 at Burauen, Leyte, Leyte, Philippines.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF TWO DISINTERESTED PERSONS

We, PABLABIO P. AGAR and DANNY S. SY, both of legal ages, Filipinos and long-time residents of Barangay District I Burauen, Leyte, after having been sworn to in accordance with law, hereby depose and state: THAT---

1. We know personally the spouses SAMSON M. TAN & WENDY K. TAN, close neighbors and long time family friends in Barangay District I Burauen, Leyte;

2. We also know personally Queeny K. Tan who was born on August 5, 1989 at Burauen, Leyte, Leyte to be the daughter of aforesaid spouses;

3. We are familiar with the fact of birth and parentage of said Queeny K. Tan, as we are bonafide residents of Barangay District I Burauen, Leyte, where she grew up and where his parents established their residence.

4. We are not related by blood or affinity with Queeny K. Tan or his parents.

5. We are executing the foregoing affidavit in order to establish the fact of birth and parentage of said Queeny K. Tan.

IN WITNESS WHEREOF, we have hereunto set our hands this 04 DECEMBER 2015 at Burauen, Leyte, Philippines.

___________________

______________________ PABLABIO P. AGAR DANNY S. SY

Affiant

Affiant

SUBSCRIBED AND SWORN to before me this 04 December 2015 at Burauen, Leyte, by PABLABIO P. AGAR and DANNY S. SY, who are personally known to me, who are the same persons who personally signed before me the foregoing affidavit and acknowledged that they executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT RE: ONE & SAME PERSON

I, PABLABIO P. AGAR, of legal age, Filipino, married, and a resident of Barangay District I Burauen, Leyte, after having been first sworn according to law, hereby depose and state: THAT---

1. I was born to parents ROY B. AGAR and SHARON K. PADO on 16 MARCH 1960.

2. I am presently a Brgy. Captain of Barangay District I, Burauen, Leyte, and popularly known in the community by my alias PABS AGAR.

3. That is why when my friend, CORINA SAM and MANITA KIM in the USA sent me financial assistance through the Moneygram, they addressed me (the receiver) in my alias as PABS AGAR.

4. I am executing this affidavit to vouch that PABS AGAR is one and the same person as herein affiant PABLABIO P. AGAR.

IN TRUTH WHEREOF, I have hereunto affixed my signature this 4

December 2015 at Burauen, Leyte, Philippines.

____________________PABLABIO P. AGAR @ PABS AGAR Affiant

SUBSCRIBED AND SWORN to before me this 4th of December 2015 at Burauen, Leyte, by PABLABIO P. AGAR, who has satisfactorily proven his identity to me through his Professional Drivers License No. H02-55-000555valid until 3-16-16, that he is the same person who personally signed the foregoing affidavit before me and acknowledged that he executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF ADMISSION OF PATERNITY

I, MANUEL B. SUYOM, of legal age, Filipino citizen, married and a resident of Burauen, Leyte, after having been sworn to an oath in accordance with law, hereby depose and state: THAT---

1. I am the biological father of a girl registered with the Office of the Civil Registrar of Burauen, Leyte, under the name of ANABELLE M. ABE, born on August 5, 1989 at Burauen, Leyte, Leyte.

2. There was an entry of the fathers name in the aforesaid Certificate of Live Birth. However, at the time said birth was registered I was not yet legally married with the mother of the girl. We were married on 01 December 2015 by Fr. Kenneth Quejada, Parish Priest of Sto. Nino Church, Burauen, Leyte.

3. To straighten the birth records of my child, it is now my great desire to admit her as being my legitimated child, and by virtue of this Affidavit of Admission of Paternity, the contract of marriage, and pursuant to Article 177 of the Family Code of the Philippines, she should henceforth be known as ANABELLE ABE SUYOM..

5. I am executing this affidavit to attest to the truth of the foregoing facts for whatever legal purpose/s this may serve.


_____________________MANUEL B. SUYOMAffiant

SUBSCRIBED AND SWORN to before me this 4th of December 2015 at Burauen, Leyte, by MANUEL B. SUYOM., personally known to me by exhibiting his CTC No. 09271947 issued on 12/3/15 at Burauen, Leyte, who is the same person who personally signed before me the foregoing affidavit and acknowledged that he executed the same.

Doc. No. 49Page No.18Book No. XXV

SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xA F F I D A V I T

I, MARY JANE MANALO, of legal age, single, Filipino, with office address at 2/F Macapagal Bldg., Real Street Burauen, Leyte, after having been duly sworn depose and say:

1. That I am the Secretary of Atty. Ken Louwen M. Quejada.

2. That on OCTOBER 04, 2015, I mailed at the Burauen, Leyte Post Office by registered mail with return card, a copy of a MOTION TO DECLARE IN DEFAULT to be filed with the Metropolitan Trial Court, Branch 01, Burauen, Leyte, in Civil Case No. 19-06601 entitled Winston Garcia v. Manuel B. Suyom, et al. for Qualified Theft, addressed to MANUEL Manny SUYOM, with address B23 L2 KVP Bliss, Sagkahan, Burauen, Leyte, with instructions to the post office to return the same if not received by the addressees within 10 days from notice.

3. A Registry Receipt No. 2232 for said mailing of the copy of the motion for defendants was attached to the original copy of said motion filed/mailed with the Honorable Court on same date.

3.On DECEMBER 4, 2015, I personally retrieved from the Burauen, Leyte Postmaster the REGISTRY RETURN RECEIPT for the registered mail for MANUEL SUYOM, which was received personally by Manuel Suyom on DECEMBER 3, 2014. Hereto attached is the REGISTRY RETURN CARD as PROOF OF SERVICE to the defendants of the aforesaid motion.

IN WITNESS WHEREOF, I have hereunto set my hand this 5 DECEMBER 2015 at Burauen, Leyte, Philippines.

MARY JANE MANALOAffiant

SUBSCRIBED AND SWORN to before me this 5 DECEMBER 2015 at Burauen, Leyte, affiant personally known to me to be the same person who executed this affidavit.


SERIES OF 2016

To: The Register of Deeds

Burauen, Leyte-----------------------------------------------/

RE: TCT No. T-93411

The undersigned petitioner WINSTON PACENCIA GARCIA, through his uncle MIGUEL L. GARCIA, after being first sworn according to law, deposeth and sayeth: THAT

1. He is of legal age, Filipino, married to Mary Ann B. Garcia, a resident of Sagkahan, Burauen, Leyte and the registered owner in fee simple of the real property situated in Barangay 101 Sagkahan, Burauen, Leyte and covered by Transfer Certificate of Title No. T-93411 issued by the Register of deeds of Burauen, Leyte, the owners duplicate of which title being submitted herewith;

2. The said certificate of title contains an annotation of encumbrance relating to contingent liabilities of the property therein described to possible claims of other heirs, creditors, and other persons who might have been deprived of lawful participation in the estate of the deceased SPS. EDWARD N. GARCIA and ESMERALDA PACENCIA GARCIA in accordance with Section 4, Rule 74 of the Rules of Court said encumbrance being annotated as per P.E. No. 6308- T-30862 on 14 August 2008;

3. The statutory period of two (2) years has already elapsed since the extrajudicial settlement and distribution of said estate as registered on 14 August 2008 and notwithstanding thereof no claim has ever been presented by any party whomsoever to this date;

WHEREFORE, this PETITION is hereby made to the Register of Deeds of Burauen, Leyte pursuant to LRC Circular No. 119, Series of 1960, to cancel the aforementioned statutory lien or encumbrance on said Transfer Certificate of Title No. T-93411 as per Entry No. 6308- T-30862, in the manner provided by law.

Burauen, Leyte. December 04, 2015.

By:

PABLABIO P. AGARAffiant



SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ x.

AFFIDAVIT RE:

CHANGE OF COLOR

I, PABLABIO P. AGAR, of legal age, Filipino, married and with postal address at B23 L2 KVP Bliss, Sagkahan, Burauen, Leyte, Philippines, after been sworn according to law, hereby depose and state: THAT---

I am the owner and possessor of a motor vehicle particularly described as follows:

Make/Type

:ISUZU Sportivo XMotor Number:D4BXL237769Chassis Number`:KMJFD38XPLJ092600

Plate Number:ABL-3990CERT. OF REGIS.:71996984 dated June 27, 2015MV File Number:1312-210789

Sometime this October 2015, I engaged the services of Isuzu Motors Services Center to change the color of said vehicle from SILVER to ASH BEIGE. The job has long been finished.

This affidavit is executed to attest to the truth of the above facts for the purpose of CHANGE OF COLOR and for whatever legal purpose this may serve.

IN IN WITNESS WHEREOF, I have hereunto set my hand this 04 December 2015 at Burauen, Leyte, Philippines.


SUBSCRIBED AND SWORN to before me this 4th of December 2015 at Burauen, Leyte, by PABLABIO P. AGAR., personally known to me by exhibiting his CTC No. 09271947 issued on 12/3/15 at Burauen, Leyte, who is the same person who personally signed before me the foregoing affidavit and acknowledged that he executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xJOINT AFFIDAVIT OF INTENT TO MARRY

We, MANUEL BARGO SUYOM and APRIL MACARAIG ABE, both of legal ages, Filipino citizens, singles, and residents of Sagkahan, Burauen, Leyte and Villareal, Western Samar respectively, after being first sworn according to law, hereby depose and state: THAT---

1. April is the fiance of Manuel, both engaged to be married under the Civil Law of the Philippines;

2. Because of our love for each other, we formally express our willingness and intent to marry each other, and we are willing to marry each other in Villareal, Western Samar before the Municipal Mayor of said municipality;

3. We are executing this joint affidavit to attest to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 04 December 2015 at Burauen, Leyte, Philippines. ___________________

________________

MANUEL B. SUYOM

APRIL M. ABEAffiants

SUBSCRIBED AND SWORN to before me this 4th of December 2015 at Burauen, Leyte, Leyte, Philippines, affiants exhibiting to me their Professional Regulation Commission ID Card No. E2-0017934 dated 6/8/06 and Philippine Passport No. XX0603984 issued on 24 March 2015 respectively for identification purpose.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xSELLERS AFFIDAVIT OF NON-IMPROVEMENT

I, MANUEL B. SUYOM, of legal age, Filipino, married and a resident of Sagkahan, Burauen, Leyte, after having been first sworn according to law, hereby depose and state: THAT---

1. I am the seller of a parcel of residential land situated at Brgy. 101, Sagkahan, Burauen, Leyte covered by Transfer Certificate of Title no. T-93411 and designated as Lot No. 949-C, PCU-08-000289 x x x containing an area of 500 sq.m. more or less.

2. The said parcel of land was sold to PABLABIO P. AGAR in a Deed of Absolute Sale under Doc. No. 34, Page No. 7, Book No. 59, s. 2015 of Notary Public Ken Louwen M. Quejada

3. The said lot has no improvement whatsoever.


MANUEL B. SUYOMAffiant

SUBSCRIBED AND SWORN to before me this 04 November 2015 at Burauen, Leyte, affiant exhibiting to me his CTC No. 17790133 issued on December 01, 2015 at Burauen, Leyte, Leyte, Philippines.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF NON-TENANCY

I, PABLABIO P. AGAR, of legal age, Filipino, single and presently the PRESIDENT of the ,REALTY INDUSTRIES Inc., Burauen, Leyte, after being first sworn according to law, hereby depose and state: THAT---

1. Our corporation, REALTY INDUSTRIES, INC. is the registered owner and possessor of the following parcels of residential land covered under the Torrens system, to wit:

1. TCT T-11009 to 11015

10. T-27051

2. T-3050

11. T-2972

3. T-3052

12. T-2978

4. T-3053

13. T-2975

5. T-3055

14. T-2928

6. T-20999

15. T-3076

7. T-21000

16. T-3276

8. T-22038 to T-22047

17. T-3303

9. T-23049

2. These parcels of titled residential lands are not tenanted.

3. I execute this affidavit to attest to the truth of the foregoing facts.



SUBSCRIBED AND SWORN to before me this 04 December 2015 at Burauen, Leyte, affiant exhibiting to me his CTC No. 17790133 issued on December 01, 2015 at Burauen, Leyte, Leyte, Philippines.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF OWNERSHIP

I, MANUEL B. SUYOM, of legal age, Filipino, married and a resident of Brgy. 101, Sagkahan, Burauen, Leyte, after having been sworn to in accordance with law, hereby depose and state: THAT---

1. I am the lawful owner of the herein described home appliances, to wit:

a) One (1) unit Refrigerator SAMSUNG w/ SN 167C362;

b) One (1) unit CTV 21 SAMSUNG w/ SN 19636043

c) One (1) unit CTV 21 LG w/ SN 40807667

2. The above listed items are in my current possession, and to be used as security and/or collateral for renewal of my loan with JGC Financing Company Inc., located at Avenida Veteranos, Burauen, Leyte.

3. I execute this affidavit to attest the truthfulness of the foregoing facts of ownership and for whatever legal purpose it may serve best.


MANUEL B. SUYOMAffiant

SUBSCRIBED AND SWORN to before me this 4 December 2015 at Burauen, Leyte, Leyte, Philippines.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF AGGREGATE TOTAL

AGRICULTURAL LANDHOLDINGS

OF DECEDENT EDWARD NOLASCO GARCIA

I, PABLABIO P. AGAR, of legal age, Filipino, married and a resident of Sagkahan, Burauen, Leyte, after having been sworn according to law, hereby depose and state: THAT---

1. I am the Attorney-in-Fact of the Heirs of Edward N. Garcia, who died on May 1, 2009; hereto attached in evidence are: (1) the Special Power of Attorney executed by Everlyn Garcia Molina, Juan Garcia, Eunice Garcia, Anna D. de Guia, Ellen De Guzman Reyes, Estelita Therese P. De Guzman and Maria Gerphil de Guzman, and (2) the Death Certificate of Edward N. Garcia.

2. Pursuant to Sec. 6 of RA 6657, we are applying for retention of 7.2758 has. of the aggregate total agricultural landholdings throughout the Philippines of the decedent Edward N. Garcia, the muniments of titles hereto attached, consisting of the following:

a) Lot 3129, Sagkahan, Burauen, Leyte (Tax Decl. 00201960)0.29 has.

b) Lot 2737, Utap, Burauen, Leyte (ARP 99-34009-00034 R-10)-4.2893 has.

c) Lot 6394, Babatngon, Leyte (ARP 0004-R-10) 2.7042 has.

3. As each heir is allowed to retain three (3) hectares out of the total landholdings for actual tilling/managing, all the seven (7) above-named heirs hereby adjudicate, as they have executed an Extrajudicial Settlement to divide and partition the estate of the decedent Edward N. Garcia pro indiviso, the above mentioned agricultural lands and thus qualify to apply for their retention.

4. This affidavit is executed to support the application for retention and for the corresponding certificate of retention to be issued by the Department of AgrarianReform.





SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF SELLER AND BUYER

We, MANUEL B. SUYOM and PABLABIO P. AGAR, both of legal age, Filipinos, and residents of Villareal, Western Samar and Sagkahan, Burauen, Leyte respectively, after being first sworn according to law, hereby depose and state: THAT---

The first named affiant is the seller of a portion of a parcel of agricultural land at Barangay District I, Burauen, Leyte containing 30,000 sq.m. only to the second named affiant under ARP No. 00289 R-18, evidenced by a Deed of Absolute Sale of a Portion of Land dated 03 December 2015 registered under Doc. No. 37, page No. 09, Book No. LIX, s. 2015 of Notary Public Ken Louwen M. Quejada.

At the time of the sale, there is no existing improvements found thereon declared in sellers name, and that the land is not tenanted.

We execute this affidavit to establish the aforestated facts for conveyancing purposes and for such other legal purpose this may serve.


____________________

____________________ MANUEL B. SUYOM

PABLABIO P. AGAR-A f f i a n t s-



SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT TO SUPPLY NAME

I, MANUEL P. SUYOM, of legal age, Filipino, married and a resident of Brgy. 101, Sagkahan, Burauen, Leyte,, after having been sworn according to law, hereby depose and state: THAT---

1. I am the father of ANABELLE A. SUYOM, who was born on August 5, 1989 in Burauen, Leyte;

2. The said birth was registered with the Office of the Local Civil Registrar of Manila, but her first name was left blank, as I and my wife have not yet decided on a name to give her upon registration.

3. Subsequently upon baptism, she was given the name ANABELLE A. SUYOM, the name she has been using since then.

4. Unfortunately, due to inadvertence, we failed to supply her first name in her Certificate of Live Birth with the Local Civil Registrar of Tacloban up to this time.

3. I am executing this affidavit to attest to the truth of the foregoing facts and to further supply the true and real name of my daughter in her birth registry No. 5757.


MANUEL B. SUYOM

Affiant/Father

SUBSCRIBED AND SWORN to before me this 4 December 2015 at Burauen, Leyte, affiant exhibiting to me his SSS No. 05-0048-2399.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xJOINT AFFIDAVIT OF SUPPORT

We, SPS. MANUEL S. SUYOM and APRIL A. SUYOM, both of legal age, Filipino citizens and residents of Brgy. 101, Sagkahan, Burauen, Leyte, after being first sworn according to law, hereby depose and state: THAT---

1. We are the natural parents of ANABELLE A. SUYOM, who is interested to apply for admission to Ateneo de Manila University (ADMU)..

2. We are self-employed, while our daughter is a scholar of CAP.

3. Pursuant to Art. 220 of the Family Code, we have the rights and duties within our means, among others, to support her in her educational pursuit.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this 4 December 2015 at Burauen, Leyte, Philippines.

___________________

________________MANUEL S. SUYOM

APRIL A. SUYOM

Father

Mother

SUBSCRIBED AND SWORN to before me this 04 December 2015 at Burauen, Leyte, affiants exhibiting to me their Community Tax Certificates Nos. CC19003/9606639 and CC19003/9606640 both issued on 01 December 2015 at Burauen, Leyte respectively.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF UNDERTAKING

I, PABLABIO P. AGAR, of legal age, Filipino, married and a resident of Burauen, Leyte, after having been first sworn according to law, hereby depose and state: THAT---

1. I am the owner of a ISUZU Sportivo X with Plate No. ABL-3990, which I have changed the color from silver to ash beige.

2. That said vehicle was apprehended by the LTO, and my drivers license was confiscated as a result of said apprehension, for reason that the process for the change of color has not yet been processed with the LTO.

3. I shall undertake to have the change of color processed and completed with the LTO.

4. I shall further undertake not to use the said vehicle pending the processing of the change of color with the LTO.

5. Pending the process and in view of this undertaking, it is requested that the drivers license be returned to PABLABIO P. AGAR.

Affiant further sayeth naught.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this 4 December 2015 at Burauen, Leyte, Philippines.




SERIES OF 2016

VERIFICATION AND CERTIFICATION

OF NON-FORUM SHOPPING

I, PABLABIO P. AGAR, of legal age, Filipino, married and a resident of Burauen, Leyte, under oath state: THAT---

I am the officer-in-charge of herein plaintiff, Realty Industries Incorporated, and duly authorized by a Board Resolution No. 121 to represent the plaintiff corporation in the above-entitled case; that I have caused the foregoing extrajudicial foreclosure application to be prepared and filed; that I have read and fully understood all the allegations therein contained; and that the same are all true and correct according to my own personal knowledge and belief, and based on genuine and authentic documents; and further,

I CERTIFY that plaintiff had not commenced any action against the defendant for the same cause and over the same subject matter, nor is there any case pending before the Supreme Court, Court of Appeals, court or any agency or tribunal, judicial or administrative; that we undertake to inform this Court of any action pending or otherwise over the same cause or subject matter within five (5) days from date of knowledge.



SUBSCRIBED AND SWORN to before me this 4th of December 2015 at Burauen, Leyte, by PABLABIO P. AGAR, personally known to me by exhibiting his CTC No. 09271947 issued on 12/3/15 at Burauen, Leyte, who is the same person who personally signed before me the foregoing affidavit and acknowledged that he executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xAFFIDAVIT OF SERVICE/MAILING

I, EPIFANIO DE LOS SANTOS, Head-Collection Department of the REALTY INDUSTRIES INCORPORATED, Burauen, Leyte, under oath state: THAT

On OCTOBER 1, 2015, I mailed by registered mail a legible copy of the DEMAND LETTER with NOTICE OF DISHONOR dated September 28, 2015 to PABLABIO P. AGAR in the Post Office of Burauen, Leyte in a sealed envelop with instruction to the postmaster to return the mail to sender after ten (10) days if undelivered, as evidenced by REGISTRY RECEIPT No. 1121 HERETO ATTACHED as proof of service, pursuant to Sections 7 and 13 of Rule 13 of the 1997 Rules of Civil Procedure. The registry return card shall be filed immediately upon its receipt by the sender, or in lieu thereof, the unclaimed letter together with the certified or sworn copy of the notice given by the postmaster to the addressee.


EPIFANIO DE LOS SANTOS

Affiant/Sender

SUBSCRIBED AND SWORN to before me this 4th of December 2015 at Burauen, Leyte, by EPIFANIO DE LOS SANTOS., personally known to me by exhibiting his CTC No. 09271947 issued on 12/3/15 at Burauen, Leyte, who is the same person who personally signed before me the foregoing affidavit and acknowledged that he executed the same.


SERIES OF 2016


PROVINCE OF LEYTE

) S.S.

Municipality of Burauen) x ------------------------------------ xSECRETARYS CERTIFICATE

I, PABLABIO P. AGAR, of legal age, Filipino, married and a resident of Barangay District I, Burauen, Leyte, after being first sworn according to law, hereby depose and state: THAT---

1. I am the Secretary of REALTY INDUSTRIES INCORPORATED, a corporation duly organized and existing under and by virtue of the laws of the Philippines, with business address at Brgy. 82, Marasbaras, Burauen, Leyte.

2. As such, I have in custody and possession the corporate books and other records of the corporation, including the minutes of the board and stockholders meetings.

3. At the duly constituted special meeting on 1 December 2015, the Board of Directors of the corporation unanimously passed the following:

BOARD RESOLUTION No. 08

Series of 2015

RESOLVED, AS IT IS HEREBY RESOLVED, that Board Chairman MANUEL B. SUYOM be given full power and authority to execute and sign an AFFIDAVIT OF LOSS of CERTIFICATE OF REGISTRATION No. 3731647-3 issued on 3 November 2015 by LTO Burauen, Leyte District Office, of one HONDA motorcycle, s. TMX 155S7, with Motor No. KB506058030684E bearing Plate No. TO3739, registered in the name of this corporation, with request of reissuance with the Land Transportation Office of a duplicate copy of said lost original Certificate of Registration.

4. The foregoing are in accordance with the records of the Corporation presently in my custody.


PABLABIO P. AGARCorporate Secretary

SUBSCRIBED AND SWORN to before me this 4 December 2015 at Burauen, Leyte, affiant being personally known to the undersigned notary public.


SERIES OF 2016

St. Pauls School of Business and LawCampetic Palo, Leyte

IN PARTIAL FULFILLMENT

OF THE

REQUIREMENTS

IN

LEGAL FORMS

Submitted By:

Ken Louwen Quejada

BL-3

Submitted To:

Atty. Leo Giron

Professor

ATTY. JOEBAN R. PAZA

Notary Public for Burauen, Leyte

Commission No: 2015-12-01 until 31 Dec. 2016

Roll No. 90500

IBP Lifetime No. 01500

PTR No. 8252222; 12-1-15; Tacloban City

MCLE Compliance No. V-0009998; 6-06-15

Poblacion District II, Burauen, Leyte, Philippines




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ATTY. KEN LOUWEN M. QUEJADA

Notary Public for Tacloban City, Leyte


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2/F Macapagal Bldg., Real Street, Tacloban City




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