Legal Forms Project

Republic of the Philippines
PROVINCE OF LEYTE
Municipality of Burauen )
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) S.S.
AFFIDAVIT 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. 22
Page No.02
Book No. XVV
SERIES OF 2016

PROVINCE OF LEYTE
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
)
) S.S.
x ------------------------------------ x
AFFIDAVIT 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
Burauen, Leyte, Philippines.
Doc. No. 23
Page No.03
Book No. XVV
SERIES OF 2016

PROVINCE OF LEYTE
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Roll No. 90500
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) S.S.
AFFIDAVIT 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
Affiant
____________________
JANE Q. AGAR
Affiant
SUBSCRIBED AND SWORN to before me this 4th day of December

2015 at Burauen, Leyte, Leyte, Philippines.
Doc. No. 24
Page No.04
Book No. XVV
SERIES OF 2016

PROVINCE OF LEYTE
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Roll No. 90500
)
) S.S.
AFFIDAVIT OF LOSS
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 04 th day of
__________________
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.
Doc. No. 25
Page No.05
Book No. XVV
SERIES OF 2016

PROVINCE OF LEYTE
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Roll No. 90500
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) S.S.
JOINT 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.
Doc. No. 26
Page No.06
Book No. XVV
SERIES OF 2016

PROVINCE OF LEYTE
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) S.S.

Roll No. 90500
JOINT 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: THAT1. 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
01 day of December, 2015 at Burauen, Leyte, Leyte, Philippines.
st
_________________________
ROY YU TAN
Affiant
ID No. MH-02356
_______________________
MAY AGAR SY
Affiant
ID No. CL00256
SUBSCRIBED AND SWORN to before me this 04th day of

December, 2015 at Burauen, Leyte, Leyte, Philippines.
Roll No. 90500
Doc. No. 27
Page No.07
Book No. XVV
SERIES OF 2016
PROVINCE OF LEYTE
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AFFIDAVIT 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
Affiant
______________________
DANNY S. SY
Affiant

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.

Roll No. 90500
Doc. No. 28
Page No.08
Book No. XVV
SERIES OF 2016
PROVINCE OF LEYTE
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) S.S.
AFFIDAVIT 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
____________________
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. H02-55000555valid 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.

Roll No. 90500
Doc. No. 29
Page No.08
Book No. XVV
SERIES OF 2016
PROVINCE OF LEYTE
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) S.S.
AFFIDAVIT 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.
IN WITNESS WHEREOF, I have hereunto set my hand this 04
_____________________
MANUEL B. SUYOM
Affiant
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.

Roll No. 90500
Doc. No. 49
Page No.18
Book No. XXV
SERIES OF 2016

PROVINCE OF LEYTE
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) S.S.
AFFIDAVIT
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.
DECEMBER 2015 at Burauen, Leyte, Philippines.
MARY JANE MANALO

Affiant
SUBSCRIBED AND SWORN to before me this 5 DECEMBER
2015 at Burauen, Leyte, affiant personally
known
toBurauen,
me toLeyte
be the
Notary
Public for
Commission
No:
2015-12-01
until
31
Dec. 2016
same person who executed this affidavit.
Roll No. 90500
Doc. No. 50
Page No.19
Book No. XXV
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. AGAR
Affiant
R. PAZA
SUBSCRIBED AND SWORN to before me thisATTY.
04 JOEBAN
December
2015 at
Doc. No. 51
Page No.19
Book No. XXV
SERIES OF 2016

Roll No. 90500

PROVINCE OF LEYTE
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) S.S.
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
Motor Number
Chassis Number`
Plate Number
CERT. OF REGIS.
MV File Number
:
:
:
:
:
:
ISUZU Sportivo X
D4BXL237769
KMJFD38XPLJ092600
ABL-3990
71996984 dated June 27, 2015
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
Commission
No: 2015-12-01
until 31 Dec. 2016
PABLABIO
P. AGAR
Roll No. 90500
AffiantNo. 01500
IBP Lifetime
Poblacion District
II, Burauen, Leyte, Philippines
th
SUBSCRIBED AND SWORN to before me this 4 of December 2015

at Burauen, Leyte, by PABLABIO P. AGAR., personally known to me by
Doc. No. 52
Page No.20
Book No. XXV

SERIES OF 2016

PROVINCE OF LEYTE
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) S.S.
JOINT 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.
___________________
MANUEL B. SUYOM
________________
APRIL M. ABE
Affiants

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.
Doc. No. 53
Page No.21
ATTY. KEN LOUWEN M. QUEJADA

Notary Public for Tacloban City, Leyte
Roll No. 90112
2/F Macapagal Bldg., Real Street, Tacloban City
Book No. XXV

SERIES OF 2016

PROVINCE OF LEYTE
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)
) S.S.
SELLERS 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. SUYOM
Affiant
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.
Doc. No. 54
Page No.22
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
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) S.S.
AFFIDAVIT 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.
2.
3.
4.
5.
6.
7.
8.
9.
TCT T-11009 to 11015

T-3050
T-3052
T-3053
T-3055
T-20999
T-21000
T-22038 to T-22047
T-23049
11.
12.
13.
14.
15.
16.
17.
10. T-27051
T-2972
T-2978
T-2975
T-2928
T-3076
T-3276
T-3303
2. These parcels of titled residential lands are not tenanted.

3. I execute this affidavit to attest to the truth of the foregoing facts.
PABLABIO P. AGAR
Affiant
Burauen, Leyte, affiant exhibiting to me his CTC No. 17790133 issued on
December 01, 2015 at Burauen, Leyte, Leyte, Philippines.
Doc. No. 55
Page No.23
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
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)
) S.S.
AFFIDAVIT 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. SUYOM
Affiant
Burauen, Leyte, Leyte, Philippines.
Doc. No. 56
Page No.24
Book No. XXV
SERIES OF 2016

PROVINCE OF LEYTE
x ------------------------------------ x

Roll No. 90112
)
) S.S.
AFFIDAVIT OF AGGREGATE TOTAL

AGRICULTURAL LANDHOLDINGS
OF DECEDENT EDWARD NOLASCO GARCIA
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.
PABLABIO P. AGAR
Affiant
Doc. No. 57
Page No.25
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
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) S.S.
AFFIDAVIT 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-

Doc. No. 58
Page No.26
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
x ------------------------------------ x
)
) S.S.
AFFIDAVIT 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
Burauen, Leyte, affiant exhibiting to me his SSS No. 05-0048-2399.
Doc. No. 59
Page No.27
Book No. XXV
SERIES OF 2016

PROVINCE OF LEYTE
x ------------------------------------ x

Roll No. 90112
)
) S.S.
JOINT 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.
4 December 2015 at Burauen, Leyte, Philippines.
___________________
MANUEL S. SUYOM
Father
________________
APRIL A. SUYOM
Mother

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.
Doc. No. 60
Page No.28
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
x ------------------------------------ x
)
) S.S.
AFFIDAVIT OF UNDERTAKING
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.
4 December 2015 at Burauen, Leyte, Philippines.
PABLABIO P. AGAR
Affiant
Doc. No. 61
Page No.29
Book No. XXV
SERIES OF 2016

Roll No. 90112
VERIFICATION AND CERTIFICATION

OF NON-FORUM SHOPPING
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.
PABLABIO P. AGAR
Affiant
at Burauen, Leyte, by PABLABIO P. AGAR, personally known to me by
Doc. No. 62
Page No.30
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
x ------------------------------------ x
)
) S.S.
AFFIDAVIT 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.
Doc. No. 63
Page No.31
Book No. XXV
SERIES OF 2016

Roll No. 90112

PROVINCE OF LEYTE
x ------------------------------------ x
)
) S.S.
SECRETARYS CERTIFICATE
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. AGAR
Corporate Secretary
Burauen, Leyte, affiant being personally known to the undersigned notary
public.
Doc. No. 64
Page No.32
Book No. XXV
SERIES OF 2016

Roll No. 90112
St. Pauls School of Business and Law

Campetic Palo, Leyte
IN PARTIAL
FULFILLMENT
OF THE
REQUIREMENTS
IN
LEGAL FORMS
Submitted By:
Ken Louwen Quejada
BL-3
Submitted To:
Atty. Leo Giron
Professor

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Republic of the Philippines

Republic of the Philippines

ATTY. JOEBAN R. PAZA

Republic of the Philippines

ATTY. JOEBAN R. PAZA

SUBSCRIBED AND SWORN to before me this 4th day of December

Republic of the Philippines

ATTY. JOEBAN R. PAZA

Republic of the Philippines

ATTY. JOEBAN R. PAZA

JOINT AFFIDAVIT OF PARENTS

We, PABLABIO P. AGAR and JANE Q. AGAR, both of legal age,

SUBSCRIBED AND SWORN to before me this 4 December

Republic of the Philippines

ATTY. JOEBAN R. PAZA

JOINT AFFIDAVIT OF COHABITATION

SUBSCRIBED AND SWORN to before me this 04th day of

AFFIDAVIT OF TWO DISINTERESTED PERSONS

SUBSCRIBED AND SWORN to before me this 04 December 2015 at

ATTY. JOEBAN R. PAZA

AFFIDAVIT RE: ONE & SAME PERSON

ATTY. JOEBAN R. PAZA

AFFIDAVIT OF ADMISSION OF PATERNITY

I, MANUEL B. SUYOM, of legal age, Filipino citizen, married and a

ATTY. JOEBAN R. PAZA

Republic of the Philippines

I, MARY JANE MANALO, of legal age, single, Filipino, with

MARY JANE MANALO

The Register of Deeds

IBP Lifetime No. 01500

RE: TCT No. T-93411

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

Republic of the Philippines

Sometime this October 2015, I engaged the services of Isuzu Motors

SUBSCRIBED AND SWORN to before me this 4 of December 2015

Book No. XXV

Republic of the Philippines

JOINT AFFIDAVIT OF INTENT TO MARRY

SUBSCRIBED AND SWORN to before me this 4th of December 2015

ATTY. KEN LOUWEN M. QUEJADA

Book No. XXV

Republic of the Philippines

SELLERS AFFIDAVIT OF NON-IMPROVEMENT

I, MANUEL B. SUYOM, of legal age, Filipino, married and a resident of

ATTY. KEN LOUWEN M. QUEJADA

Republic of the Philippines

TCT T-11009 to 11015

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

ATTY. KEN LOUWEN M. QUEJADA

Republic of the Philippines

2. The above listed items are in my current possession, and to be used

Republic of the Philippines

ATTY. KEN LOUWEN M. QUEJADA

AFFIDAVIT OF AGGREGATE TOTAL

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

ATTY. KEN LOUWEN M. QUEJADA

Republic of the Philippines

AFFIDAVIT OF SELLER AND BUYER

SUBSCRIBED AND SWORN to before me this 4 December 2015 at

ATTY. KEN LOUWEN M. QUEJADA

Republic of the Philippines

AFFIDAVIT TO SUPPLY NAME

1. I am the father of ANABELLE A. SUYOM, who was born on August