Republic of the Philippines )

City of Tacloban ) S.S.

AFFIDAVIT OF CONSENT

I, ____________________________, the undersigned, of legal age and with residence and postal
address at ___________________________________after having been duly sworn to in accordance with
law, hereby depose and say:

1. That I am the owner of the residential property situated at ____________________________;

2. That ___________________________ of legal age, Filipino and with residence and postal
address at ______________________________, is applying for a Business Permit at the
Municipality of Palo, Leyte;

3. That I hereby signify my written consent, freely, willingly and voluntarily to allow him to use the
above-mentioned property for his Business (Office), and consequently apply for a Business
Permit;

4. That I am executing this affidavit to attest the truth of the foregoing facts as to my undertaking to
give consent to _____________________________ in support to his application for a Business
Permit.

IN WITNESS WHEREOF, we have hereunto set our hands this ____________________ at

Tacloban City.

______________________ ________________________
Affiant (Owner) Affiant (Permitee)
CTC No.: _____ CTC No.: _____________
Issued at ______________ Issued at _____________
Issued on ______________ Issued on _____________

SUBSCRIBED AND SWORN to before me this ____________________ at Tacloban City, affiants exhibiting
to me their Community Tax Certificate Numbers written below their names.

WITNESS MY HAND AND SEAL this ________________________ at Tacloban City.

Doc. No. ______;

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