I, LYNBERG JUARIZO GARLITOS, of legal age, Filipino, and resident of
Pinoma, Cauayan City, Isabela, after having been duly sworn in accordance with law, do hereby depose and state that:
1. I am the same person executing this Instrument;
2. I am the heir of ADDIALA LUCAS-GARLITOS she being my
grandmother;
3. ADDIALA LUCAS died intestate leaving a parcel of land situated at
Victoria, San Mateo, Isabela containing an area of SEVENTEEN THOUSAND NINE HUNDRED EIGHTY-TWO (17, 982) SQUARE METERS, more or less, under Subdivision Plan for Lot 6702-B, Psd- 39644 covered by TCT No. T-24313 and declared for taxation purposes under Tax Declaration of Real Property No. 15-300029- 00740 with Property Identification No. 011-30-0029-011-06;
4. However, I found out that her name is reflected in the tax declaration is ADIOLA LUCAS;
5. I am executing this instrument to certify that ADDIALA LUCAS
appearing in the Subdivision Plan copy of which is hereto attached as Annex A and the person appearing as ADIOLA LUCAS under Tax Declaration of Real Property No. 15-300029-00740 refers to one and the same person;
6. I am executing this Instrument in support of my request for the
correction of the name of the declarant in the Tax Declaration from ADIOLA LUCAS to ADDIALA LUCAS and to declare and attest to the veracity and truthfulness of the foregoing.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ____th
day of January, 2018 hereat____________________, Philippines.
LYNBERG JUARIZO GARLITOS
Affiant
SUBSCRIBED AND SWORN TO before me this ______ day of January, 2018
hereat _________________, Isabela;
Notary Public
Doc. No. _________
Page No. _________ Book No. _________ Series of 2018.