Ss 1

REPUBLIC OF THE PHILIPPINES )
In The City of Davao )ss

x------------------------/
Joint Affidavit Of Discrepancy
We, GRACE C. FERNANDEZ and CECILE S. ENCOMIENDA, both of legal age,

Filipino, married and residents of Davao City, Philippines, respectively, after having been sworn
to in accordance with law do hereby depose and state that:
1. We personally know the person of JUNKO LIPONGO who was born on January 20,
1997 in Toka-machi-shi, 32-9 Daza Takayama Niigata-Ken;
2. That she is the child of spouses Anna Liza Alipascua Liponggo and Morio Suzuki;
3. That she intends to acquire a Japanese Visa, and one of the requirement is her mother’s
Certificate of Live Birth. However, her mother’s family name is registered as
LIPONGGO while her Certificate of Live Birth is LIPONGO;
4. That we hereby declare under oath that her mother Annna Liza Liponggo, and Anna
Liza Lipongo, refer to one and the same person;
5. That we are not related with them either by affinity or by consanguinity and that we have
no interest of whatsoever;
6. That we are executing this affidavit to attest to the truth of the foregoing averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 9 th day of March, 2016, in
the City of Davao, Philippines.
GRACE S. FERNANDEZ CECILE C. ENCOMIENDA

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 9th day of March, 2016 in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiants and that I am satisfied that they
understood and executed voluntarily the foregoing affidavit.
Republic of the Philippines)
) S.S.
Davao City . . . . . . . . . . . )
x------------------/
Affidavit Of Guardianship
I, JEANELYN ROSALYN ARCENA, of legal age, Filipino, married and a resident of

Sabroso Village, Phase 4, Ecoland, Matina, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and say that:
1. That I am the aunt of JERRICHO ROSALYN ARCENA;
2. That he is the child of my sister Jessa Rosalin Arcena who was born on January 23,
2002 in Davao City;
3. That he is now 13 years of age and his Certificate of Live Birth is a requirement for
his school;
4. That he is under my guardianship considering that his mother is out of the country;
5. That I am executing this affidavit to the truth of the foregoing averments and to
apprise the National Statistics Office (NSO) for whatever purpose this may serve to
my intent to secure an NSO authenticated Birth Certificate of my nephew.
IN WITNESS WHEREOF, I have hereunto set my hand this 9th day of March, 2016 at the
City of Davao, Philippines.
JEANELYN R. ARCENA
Affiant
SUBSCRIBED AND SWORN to before me this 9 th day of March, 2016 in the City of
Davao, Philippines and I further certify that I have personally examined the affiant and I am
satisfied that she voluntarily executed and understood her affidavit.
_________________________________
Doc No. _________

Page No. ________
Book No. ________
Series of 2016.
In the City of Davao )ss
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Affidavit Of Loss
I, MERRY CHRISTINE CONSTANTINE ABSALON, of legal age, Filipino,
single and a resident of km. 7 Hope Ave., Bangkal, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and say:
1. That I am a holder of a PROMO COUPON of BANDERA SING-

IT KATROPA, the coupon with the missing lyrics. HEAVEN is
what I texted;
2. That fortunately, on January 26, 2016 I received a message thru

text by the BANDERA that my entry coupon won;
3. That however, my said coupon was misplaced in my place of

residence and despite diligent efforts exerted to locate, the
same could not be found;
4. That it is my intent to claim my winnings, hence, this affidavit;
5. That I am executing this affidavit to attest to the truth of the

foregoing averments and to submit the same to the
BANDERA/INQUIRER Publication, for whatever purpose this
affidavit may serve to my claim of raffle prize.
IN WITNESS hereof, I have hereunto affixed my signature this

____________________, in the City of Davao, Philippines.
MERRY CHRISTINE C. ABSALON

Affiant
SUBSCRIBED AND SWORN to before me this _________________ in the

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the
affiant and that I am satisfied that the affiant understood and voluntarily executed
the foregoing.
Doc. No._________;
Page No._________;
Book No.__________;
Series of 1016.
x------------------------/
We, MANUEL R. FLORIDA and BORROMEO M. SEGOVIA, both of legal age, Filipino,
married and residents of Davao City, Philippines, respectively, after having been sworn to in
accordance with law do hereby depose and state that:
7. We personally know the persons of ALMA LAHIRA ALBARRACIN and MARY

LAHIRA ALBARACIN who are residents of 227 Papaya St., Bo. Pampangga, Davao
City ;
8. That they are sisters having been borne from spouses Santiago Fernandez Albarracin
and Teodora Makalungsod Lahira;
9. That in the Certificate of Live Birth of Mary, her family was incorrectly registered
ALBARACIN, only one R while with her sister Alma, the family name is spelled
as ALBARRACIN, with double R;
That likewise, following their Certificates of Live Birth, the same error for their family
name is registered in their respective Philippine Passport;
10. That we hereby declare under oath that Alma Lahira Albarracin and Mary Lahira
Albaracin are sisters, referring to the children of spouses Santiago Fernandez
Albarracin and Teodora Makalungsod Lahira;
no interest of whasoever;
IN WITNESS HEREOF, we have hereunto affixed our signatures this
_______________________ in the City of Davao, Philippines.
ARLENE CADAVEZ CECILE COSTAN

Affiant Affiant
SUBSCRIBED AND SWORN to before me this ____________________ in the City of Davao,

_________________________________________
x - - - - - - - - - - - - - - - - - - - - - - - - -/
A f f i d a v i t
I, DIENES V. OCAMPO, 30 years of age, Filipino and a resident of Roman
Diaz, Calinan, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and say:
6. That at about 7:00 o’clock in the evening of February 18, 2016, I

was at my store situated at _______________, calinan, Davao
City, fronting the store rented by Roldan Suello (Roldan for
short);
7. That I saw Roldan busy doing some electrical job/wirings at his

rented store space. He was to open his appliances repair shop
on the following day;
8. That while thereat, a skin-head motorcycle riding man arrived

and entered the shop. Thereafter, I saw the man talking to
Roldan while the latter was still working on his electrical chores;
9. That minutes later, another man came and talked to the skin-
head person outside the shop. I also noticed several persons
positioning themselves nearby;
10. That minutes later, while the visitors of Roldan were talking
outside the shop, the the other persons who positioned
themselves nearby hurriedly approached and announced their
authority, policemen;
11. That I saw the police officers how they arrested the motorcycle
riding skin-head person. Likewise, they forcibly arrested Roldan
who was inside the shop. One of the police officer boxed Roldan
hitting his abdomen;

foregoing averments, free from threats of intimidation, purposely
to apprise the authorities concerned of the foregoing averments.

DIENES V. OCAMPO
Affiant

the foregoing.
Doc. No._________;
Page No._________;
Book No.__________;
Series of 2016.

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit/Waiver
I, MARY JOY MAGBUTONG Y MANGGOB, of legal age, Filipino, single
and a resident of Poblacion Taocanga, Manay, Davao Oriental, Philippines, after
13. That I am the common-law wife of CPL ALENENOGENES G.

SINGCO and during our relationship, we were blessed with a
child, ZEN STEVE MAGBUTONG SINGCO. He was born on
August 2, 2014 in Davao City;
14. That my said husband died in action on May 23, 2015 in

Bagangga, Davao Oriental;
15. That being a child of an enlisted personnel, my son is entitled to

benefits;
16. That I hereby waive forty (40%) percent of the pension for my
son in favor of the father and mother of my husband,
BUENAVENTURA SINGCO and ROSALINDA G. SINGCO;

foregoing averments, free from threats of intimidation, purposely
to apprise the Arm Forces of the Philippines (AFP) of my intent
to part 40% of the pension benefit for my son.

MARY JOY M. MAGBUTONG

Affiant

the foregoing.
Doc. No._________;
Page No._________;
Book No.__________;
Series of 2016.

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Affidavit Of Loss
I, PARDEEP SINGH, of legal age, Filipino, married and a resident of 208
Begonia St., Flores Village, Bangkal, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and say:
18. That I am a holder of Non-Professional Driver License No. LO5-

15-001969 issued by the Land Transportation Office, Davao
City;
19. That unfortunately, for over-speeding last Friday afternoon, my

said license was confiscated;
20. That as such, I was issued Temporary Operator’s Permit.

However, upon arriving home, I discovered my wallet containing
the said permit to be missing;
21. That despite earnest efforts exerted to locate, the same could
not be found;
22. That I have reported the loss of my license at Police Station 3,

Matina, Davao City;
23. That the lost permit was not confiscated in violation of another
traffic rules and regulations;

foregoing averments and to submit the same to the authorities
concerned, particularly to the Land Transportation Office, Davao
City, for whatever purpose this may serve to my intent to request
for release of my Non-Professional Driver License.

PARDEEP SINGH
Affiant

the foregoing.
Doc. No._________;
Page No._________;
Book No.__________;
Series of 1016.

x------------------------/
We, ARLENE CADAVEZ and CECILE COSTAN, both of legal age, Filipino, single and
residents of Davao City, Philippines, respectively, after having been sworn to in accordance with
law do hereby depose and state that:
13. We personally know the person of APOLINARIO DAGALA AUTIDA, JR. who died
recently on February 4, 2016 in Sta. Cruz, Davao del Sur;
14. That he was married to Dahlia Dumala Bernales and out of their marriage, they were
blessed five (5) children and among them is Kent Bernales Autida;
15. That in the Certificate of Live Birth of Kent however, the father’s name was registered as
Apolinario Dagala Autida only. I should have been Apolinario
Dagala Autida, Jr. to conform with the true and correct name Kent’s father
as could be gleaned in all other documents, such as Death Certificate of Apolinario D.
Autida, Jr,, Marriage Contract and Certificate of Live Birth;
16. That we have personal knowledge of the facts above because we have been good
neighbors for along time with the Carlon family;

ARLENE CADAVEZ CECILE COSTAN

Affiant Affiant

_________________________________________
Doc.No._______;
Page No.______;
Book No.______;
Series of 2016.

x------------------------/
We, RICHARD S. FLORIDA and HERMINIA B. SIBUNGA, both of legal age, Filipino,
married and residents of Quezon Boulevard and Buhangin, Davao City, Philippines,
respectively, after having been sworn to in accordance with law do hereby depose and state:
19. Wepersonally know the person of Lucrecio Polinar Carlon who died on November 2, 1015 at
the Southern Philippines Medical Center, Bajada, Davao City;
20. That she is the child of spouses Benito Carlon and Lucia Polinar Carlon. Both parents
already died;
21. That in the Certificate of Death of his mother Lucia, the family name was erroenusly
registered as CARLOM. It should have been CARLON to conform with the
true and correct family name as could be gleaned in all of their individual personal
documents, such as Certificates of Live Birth of Benito Carlon and their children, their
Marriage Contract, etc.;
22. That we have personal knowledge of the facts above because we have been good
neighbors for along time with the Carlon family;
RICHARD S. FLORIDA HERMINIA B. SIBUNGA

Affiant Affiant

Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that he
executed voluntarily and understood the foregoing affidavit.
_________________________________________
Doc.No._______;
Page No.______;
Book No.______;
Series of 2016.

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Affidavit Of Discrepancy
I, LORENA CARLON JUATON, of legal age, Filipino, married and a resident of km. 11,
Bayview, Sasa, Davao City, Philippines, after having been sworn to in accordance with law do
hereby depose and state that:
25. That I am the eldest of the two (2) children of LUCRECIO POLINAR
CARLON;
26. That my father died on November 2, 2015 at the Southern Philippines Medical Center
(SPMC);
27. That it is our intent to claim SSS benefits; however one of the reqirements is the Death
Certificate of one of the parents. Our grandmother’s Death Certificate however shows
discrepancy on her family name. It was registered as CARLOM. It should have
been CARLON to conform with the true and correct family name as could be
gleaned in all of our individual personal documents, such as Certificates of Live Birth of
our grandfather, their Marriage Contract, Certificates of Live Birth of children, etc.;
28. That I am executing this affidavit to attest to the truth of the foregoing averments and to
submit the same to the Social Security System (SSS), in explanation to the incorrect
family name of our grandmother in her Death Certificate.

LORENA C. JUATON
Affiant

Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that she
_________________________________________
Doc.No._______;
Page No.______;
Book No.______;
Series of 2016.

x------------------------/

CARLON;
(SPMC);

LORENA C. JUATON
Affiant

_________________________________________
Doc.No._______;
Page No.______;
Book No.______;
Series of 2016.

x------------------------/

CARLON;
(SPMC);

LORENA C. JUATON
Affiant
_________________________________________
Doc.No._______;
Page No.______;
Book No.______;
Series of 2016.

x------------------------/
JOINT AFFIDAVIT
OF TWO DISINTERESTED PERSONS
(Discrepancy)
We, JOSE V. DEMERIN, JR. and AIZA S. BINASBAS, both of legal age, Filipino,
married and residents of Kalubihan, Matina and S. I. R., Matina, Davao City, Philippines,
1. That we personally know the person of JENEFFER ULAMA QUIDIG

who was born on December 21, 1980 in Luna, Kapalong, Davao of spouses Delia
Ulama and Semon Quidig;
2. That her birth was registered at the Local Civil Registrar of Kapalong, Davao and the
same was forwarded to the National Statistics Office (NSO), however, per record in the
said offices her given registered at the Local Civil Registrar of Kapalong, Davao is
JENNEFER while at the NSO, JENEFFER was as her given name;
3. That Jennefer U. Quidig per record at the Local Civil Registrar of Kapalong, Davao and
Jeneffer Ulama Quidig per NSO record, refer to one and the same person who is known
to us as JENEFFER ULAMA QUIDIG;
4. That we both have personal knowledge of the facts above because we have been good
friends for a long time;
5. That we are not related either by affinity or by consanguinity and that we have no
interest of whatsoever with Jeneffer Ulama Quidig;
6. That we are executing this affidavit to attest the truth of the foregoing averments.

JOSE V. DEMERIN, JR. AIZA S. BINASBAS

Affiant Affiant

_________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ELENA P. GUTUAL and JANET T. FORTUNA, both of legal age, Filipino, married
and residents of Cabayugan I, Sasa and Sandawa, S. I. R. New Matina, Davao City, Philippines,
respectively, after having been sworn to in accordance with law do hereby depose and state
that:
7. That we personally know the person of AULINDO DOLDOL AMAD who is the
child of spouses Aureliano Amad and Cristita Bulalong of upper Tibanban, Governor Generoso,
Davao Oriental;
8. That he isw a member of the Social Security System (SSS), and as such, he was a
holder of an SSS Identification Card;
9. That however, his SSS ID shows that his family name registered is AAMAD.
Therefore, his record in the SSS records, his family name registered is AAMAD. It
should have been AMAD to conform with the true and correct family name of Aulindo
Doldol Amad;
10. That Aulindo Doldol AAmad, per SSS record and Aulindo Doldol Amad, child of
spouses Aureliano Amad and Cristita Bulalong, refer to one and the same person
whose true and correct family name is AMAD;
11. That we both have personal knowledge of the facts above because we have been
good friends in our home province for a long time;
interest of whatsoever with the deceased Aureliano B.Amad;

ELENA P. GUTUAL JANET T. FORTUNA

Affiant Affiant

_________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ELENA P. GUTUAL and JANET T. FORTUNA, both of legal age, Filipino, married
and residents of Cabayugan I, Sasa and Sandawa, S. I. R. New Matina, Davao City, Philippines,
that:
9. That we personally know the person of AURELIANO BULALONG AMAD

who is the child of spouses Felomino Amad and Cristituta Bulalong of upper Tibanban,
Governor Generoso, Davao Oriental;
10. That Felomino Amad died on February 6, 2016 at the Southern Philippines Medical
Center, Bajada, Davao City. In the Certificate of Death however, his father’s given
name was incorrectly registered as FILOMINO. It should have been
FELOMINO to conform with the true and correct given name of the deceased’s
father as could be gleaned in the Certificate of Marriage and Certificate of Birth;
11. That Filomino Amad, father of the deceased Aureliano Bulalong Amad per
Certificate of Death and Felomino Amad, father of Aureliano Bulalong Amad per
Marriage Contract and Certificate of Birth, refer to one and the same person whose
true and correct given name is FELOMINO;
good friends in our home province for a long time;
interest of whatsoever with the deceased Aureliano B.Amad;

ELENA P. GUTUAL JANET T. FORTUNA

Affiant Affiant

_________________________________________

x------------------------/
AFFIDAVIT OF DISCREPANCY
I, LILIBETH VALERA DINOY, of legal age, Filipino, married and a resident of San
Rafael, Brgy.9-A, Marfori Heights, Davao City, Philippines, after having been sworn to in
15. That I am the same Lilibeth Catillano Valera who is the sixth (6th) of
the eight (8) children of spouses Vicente Valera and Lolita Catillano who was
born on July 3, 1985 in Malita, Davao del Sur;
16. That at 26 years of age, I was married to Ronillo Jumawan Dinoy on April 14, 2010
at the Seventh Day Adventist in S. I. R. Matina, Davao City. In our Certificate of
Marriage however, my date ofr birth was erroneously registered as 03 July 1983.
It housld have been registered as 03 July 1985 to conform with my true and
correct date of birth as could be gleaned in my NSO authenticated Certificate of Live
Birth;
17. That Lilibeth Catillano Valera whose date of birth is 03 July 1985 per NSO
Authenticated Certificate of Live Birth and Lilibeth C. Valera, whose date of
birth is 03 July 1983 per NSO authenticated Certificate of Marriage, referring to
the undersigned affiant whose true and correct date of birth is 03 July 1985;
18. That the error in the registry of my date of birth in the Certificate of Marriage is a
plain oversight on the part of the registering clerk;
19. That I am executing this affidavit to attest to the truth of the foregoing averments
purposely to submit the same to the Department of Foreign Affairs, Davao City, in
explanation of the discrepancy of my date of birth registered in my Certificate of
Marriage. .
IN WITNESS HEREOF, I have hereunto affixed my signature this _______________________ in

LILIBETH V. DINOY
Affiant

_________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ARLENE C. COSTAN and AMERICUS S. YANONG, both of legal age, Filipino,
married and residents of Ma-a and Green Meadows Subd., Brgy. Sto. Niño, Tugbok, Davao City,
Philippines, respectively, after having been sworn to in accordance with law do hereby depose
and state that:
20. That we personally know the person of JEMYR CADAYAO TAMBUCO

who is the child of spouses Myrna Cadayao and Jerry Tambuco who was born on
March 4, 1984 in Malita, Davao del Sur;
21. That her birth was registered, however, her GENDER and DATE OF BIRTH were
incorrectly registered as MALE and MARCH 4, 1987. They should have been
FEMALE and MARCH 4, 1984, respectively, to conform with her true gender
and correct date of birth;
22. That Jemyr Cadayao Tambuco whose gender and Date of Birth are registered as
Male and March 4, 1987 at her Birth Record and Jemyr Cadayao Tambuco whose
gender is Female and Date of Birth is March 4, 1984, refer to one and the same person
whose true and correct gender and date of birth are Female and March 4, 1984,
respectively;
good friends for a long time;
interest of whatsoever with Jemyr C. Tambuco;

ARLENE C. COSTAN AMERICUS S. YANONG

Affiant Affiant

_________________________________________

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit Of Loss
I, RODRIGO FLORMATA Y MIRANDA, of legal age, Filipino, married and
a resident of 33-A, Acacia St.,MonteMaria Village, Catalunan Grande, Davao
City, Philippines, after having been duly sworn to in accordance with law, do
hereby depose and say:
25. That I am a holder of a SMC Stock Certificate Preferred 2A

130752 4,000 shares issued on January 10, 2013;
26. That sometime in December 2015, I discovered the loss of my

said Certificate in my place of residence;
27. That despite earnest efforts exerted to locate, the same could
not be found;
28. That the lost Certificate was not confiscated nor sold or in any
manner alienated to a third party;

concerned, particularly to the San Miguel Corporation Stock
Transfer Service Corporation for whatever purpose this may
serve to my intent to request for issuance of another Stock
Certificate in lieu of the lost one.

RODRIGO M. FLORMATA
Affiant

the foregoing.
_______________________________
Doc. No._________;
Page No._________;
Book No.__________;
Series of 1016.

x-------------------------/
Affidavit Of Explanation
With Request for Reconsideration
I, APOLLO OCON URQUIZA, of legal age, Filipino, single and a resident of Lot
8, Blk. 4, Phase 1, Wellspring Subd., Catalunan Pequeño, Davao City, Philippines,
under oath, depose and say:
1. That I am a graduating student of the University of Immaculate

Concepcion under the course of Information Technology major in
Multimedia;
2. That one of the requirement for completion of the said course is a 486
hours On the Job Training(OJT);
3. That I have taken my 486 hours OJT at COMELEC, Region XI, District I,
Davao City, which started on July 16, 2015 and suppose to be
completed on December 18, 2015. However, due to preparation and
research for my thesis and preparation for its defense, I have completed
my OJT on January 25, 2016;
4. That however, on December 18, 2015 I have submitted partial number

of OJT hours, Picture of myself as OJT trainee with the Director of the
COMELEC and Laboratory Manual which was admitted by the Secretary
of the IT Dean’s Office;
5. That when I submitted the said documents, I had an agreement to

submit my OJT Certificate of Completion by way of a Promissory Letter
noted by Ms. Stefi Jerone Y. Sapar, OJT Coordinator, and the same is
hereto attached to form part of this affidavit;
6. That upon release of my Certificate of Completion from the COMELEC

on January 25, 2016, I wasted no time in abiding with my promise to
submit my required OJT Certificate;
7. That I am executing this affidavit to attest to the truth of the foregoing

averments, purposely to request the Registrar of the University of
Immaculate Concepcion thru the ITE Dean for consideration to accept
my Certificate of Completion.

______________________, in the City of Davao, Philippines.
APOLLO O. URQUIZA
Affiant
SUBSCRIBED AND SWORN TO before me this ___________________, in the

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant
and that I am satisfied that the affiant understood and voluntarily executed the
foregoing.
Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

x-------------------------/
With Request for Reconsideration
I, NILO M. OMBAJIN, JR., of legal age, Filipino, single and a resident of Villegas
Bldg., Phase II, Sandawa Road, SIR, New Matina, Davao City, Philippines, under oath,
depose and say:
8. That I am a graduating student of the University of Immaculate
Concepcion under the course of Information Technology major in
Multimedia;
9. That one of the requirement for completion of the said course is a 486
hours On the Job Training(OJT);
10. That I have taken my 486 hours OJT at Offsourcing, Inc., Philippines,
HAI Bldg., Bajada, Davao City, afterwhich I submitted my Certificate of
Completion at the UIC ITE Dean’s Office on December 18, 2015;
11. That the said Certificate however was not admitted by the Dean’s Office
for allegedly late in submitting;
12. That the reason why the Certificate was submitted late was that,
while the same was dated November 28, 2015, it was actually released
at 4:00 o’clock in the afternoon of December 17, 2015;
13. That although the Certificate was released late, I did not waste time
in submitting the same to the UIC Dean’s Office. However, the receiving
clerk left early and I was advised to submit it on the following day;
averments, purposely to request the Registrar of the University of
Immaculate Concepcion thru the ITE Dean for consideration to accept
my Certificate of Completion.

NILO M. OMBAJIN, JR.

Affiant
SUBSCRIBED AND SWORN TO before me this ___________________, in the

and that I am satisfied that the affiant understood and voluntarily executed the
foregoing.
Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
February 3, 2016
The Registrar
University of Immaculate Conception
Davao City
Madame:
This refers to my OJT Certificate of Completion dated November 28, 2015

which I submitted at the UIC ITE Dean’s Office on December 18, 2015.
My said certificate was not admitted by the Dean’s Office for allegedly
being late in submitting. I would like to inform our Office that while the certificates
issued by OFFSOURCING, Inc. was dated November 28, 2015, the same was
actually released to us at 4:00 o’clock in the afternoon of December 17, 2015.
After the release of the Certificate, I immediately went to the UIC Dean’s
Office to submit. However, the receiving clerk left early and we were advised to
submit on the following day.
In view thereof, I humbly request Your Goodself for reconsideration and to

please accept my Certificate of Completion for my On the Job Training.
Thank you and hope for your kind consideration.
Very respectfully yours,
NILO M. OMBAJIN, JR.

Villegas Bldg., Phase II
Sandawa Road, SIR, New Matina,
Davao City

x------------------------/
Joint Affidavit
(Cohabitation)
We, PAUL JORDAN CAMPANO PAMPLONA and KARISSA JOY
BATAO PIEDAD, 28 and 29 years old, Filipino, single and residents of Rosalina I,
Puan, Bago Gallera, Davao City, Philippines, respectively, after having been sworn to in
1. we have been living together as husband and wife without the benefit
of marriage for more than five (5) years;
2. we are of majority age, not related to each other, either by affinity or by

consanguinity and there is no legal impediment between us to marry
each other; and
4. That we are executing this affidavit with our own free act and to submit
the same to the authorities concerned for whatever purpose this may
serve to our intent to marry each other in accordance with Article 34 of
the New Civil Code of the Philippines.
IN WITNESS hereof, we have hereunto affixed our signatures this

_____________________ in the City of Davao, Philippines.
PAUL JORDAN C. PAMPLONA KARISSA JOY B. PIEDAD

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this _______________________, in

the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant
and that I am satisfied that they voluntarily executed and understood the foregoing
affidavit.
_______________________________
REPUBLIC OF THE PHILIPPINES)

x------------------------/
Joint Affidavit
We, PEPITO TOJONG and ELIZABETH P. NACILLA, both of legal age, Filipino,
single and residents of Toril and Nacilla Village, Bugac Ma-a, Davao City, Philippines,
respectively, after having been sworn to in accordance with law do hereby depose and
state that:
1. we personally know the persons of Paul Jordan C. Pamplona and

Karissa Joy B. Piedad;
2. they had been living together as husband and wife without the benefit
of marriage for more than five (5) years;
3. they are of majority age, not related to each other, either by affinity or
by consanguinity;
4. That there is no legal impediment between them to marry each other;
5. That we have personal knowledge of the facts mentioned because we

have been good friends with the couple for a long time; and
serve.

_________________________ in the City of Davao, Philippines.
PEPITO TOJONG ELIZABETH P. NACILLA

Affiant Affiant

affidavit.
_______________________________

x-------------------------/
WAIVER OF RIGHTS TO PURCHASE
I, PATROCINIO M. NEROSA, of legal age, Filipino, widower and a

resident of DDF Village, Mandug, Davao City, Philippines, under oath, depose
and say:
15. That I am an awardee of a housing project of the Social

Security System (SSS);
16. That unfortunately, for financial constraints, I failed to pay the

amortization despite the lapse of time;
17. That a third party is interested to purchase the said SSS

housing project;
18. That I hereby waive and/or relinguish all my rights and interest
unto and in favor of Mr. Danny Li E. Chuan of 250 Sapphire St.,
DDF Village, Mandug, Buhangin District, Davao City;
19. That I am executing this affidavit with my own free act,

purposely to apprise the Social Security System for the
aforementioned waiver of rights over Lot 106, Block 3, Magalang
St., Ph-5, DDF Village,Mandug, Davao City;

PATROCINIO M. NEROSA
Affiant
SUBSCRIBED AND SWORN TO before me this ___________________,

in the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined
the affiant and that I am satisfied that the affiant understood and voluntarily
executed the foregoing.
Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

x-------------------------/
I, MARISSA DOMINGO NACIONALES, of legal age, Canadian Citizen,

single and a resident of Blk.9, Lot 52, NHA Agdao, Davao City, Philippines,
20. That I am a Canadian Citizen. I have acquired my citizenship by

naturalization;
21. That I am now staying in the Philippines, particularly in Davao

City;
22. That I intend to retain or re-acquire my Filipino citizenship for

reason of my love of my country;
23. That unfortunately, there is no legal officer in Davao City today

to take my oath of allegiance;

foregoing averments purposely to submit the same to the Bureau
of Immigration in explanation for the reason of taking Oath of
Allegiance to other person authorized to administer oath.

MARISSA D. NACIONALES
Affiant

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

x-------------------------/
Affidavit Of Delayed Registration
I, ERLINDA PEPITO VAN GUNSTEREN, of legal age, Filipino, married,

and a resident of BRC, Catalunan Pequeno, Davao City, Philippines, under oath,
depose and say:
1. That I am legally married to MARINUS JOHANES

JOHANNES VAN GUNSTEREN. Our marriage was
solemnized on March 20, 1996 in Rotterdam, Netherland;
2. That however, I have inadvertently failed to register our marriage

at the Philippine Embassy in Netherland;
3. That I failed to register our marriage because I thought that it has

to be registered only in the Netherland where our marriage took
place;

concerned, particularly to the Department of Foreign Affairs, Davao
City Office in support of my delayed registration of marriage.

ERLINDA P. VAN GUNSTEREN

Affiant

the affiant and that I am satisfied that the affiant, assisted by his instrumental
witnesses, understood and voluntarily executed the foregoing.
Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

x------------------------/
Joint Affidavit
We, MERIEL J. NARVACAN and MIKHAIL DOMINGO, both of legal age,

Filipino, married and residents of Cabantian and km. 22, Los Amigos, Tugbok, Davao
City, Philippines, respectively, after having been sworn to in accordance with law do
1. we personally know the persons of Henry Bañaria Lomada and

Kristine Diana Palarca Villanueva;
of marriage for more than five (5) years, since September 25, 2003, up
to the present;
3. they are of majority age, not related to each other, either by affinity or
by consanguinity;
4. there is no legal impediment between them to marry each other;
5. We have personal knowledge of the facts mentioned above because

we have been good friends with the couple for a long time; and
serve.

_____________________ of December, 2015, in the City of Davao, Philippines.
MERIEL J. NARVACAN MIKHAIL DOMINGO

Affiant Affiant

the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the
affiants and that I am satisfied that they voluntarily executed and understood the
foregoing affidavit.
_______________________________

x------------------------/
Joint Affidavit
(Cohabitation)
We, HENRY BAÑARIA LOMADA and KRISTINE DIANA PALARCA, 33

and 29 years old, Filipino, single and residents of No. 728 Ponciano Reyes St., Davao
3. we have been living together as husband and wife without the benefit
of marriage for more than five (5) years, since 2009, to date;

consanguinity and there is no legal impediment between us to marry
each other; and

_____________________ in the City of Davao, Philippines.
HENRY B. LOMADA KRISTINE DIANA P. VILLANUEVA

Affiant Affiant

affidavit.
_______________________________

x------------------------/
Joint Affidavit
We, MARIA THERESA J. DUMAGAN and CELEDONIO A. CALIVOSO, both of

legal age, Filipino, single and residents of Abayon Village and Durian Village, Calinan,
Davao City, Philippines, respectively, after having been sworn to in accordance with law
do hereby depose and state that:
7. we personally know the persons of Lemuel Castro Esquibel and

Janeth Saron Sastrillo;
of marriage for more than five (5) years, since September 25, 2003, up
to the present;
9. with their relationship, they had been blessed with three (3) children:
Name Age Date of Birth
Jaderick Lovies S. Esquibel 9 August 31,2006

Jude Lewy S. Esquibel 5 December 14,2009
Lesly Jane S. Esquibel 2 January 2, 2013
10. they are of majority age, not related to each other, either by affinity
or by consanguinity and there is no legal impediment between them to
marry each other;
11. We have personal knowledge of the facts mentioned above

because we have been good neighbors in our place of residence for a
long time; and
12. That we are executing this affidavit with our own free act and to
submit the same to the authorities concerned for whatever purpose this
may serve.

MARIA THERESA J. DUMAGAN CELEDONIO A. CALIVOSO

Affiant Affiant

affidavit.
_______________________________
x------------------------/
Joint Affidavit
(Cohabitation)
We, LEMUEL CASTRO ESQUIBEL and JANETH SARON SASTRILLO, both 34

years old, Filipino, single and residents of Purok 38 Abayon Village, Calinan, Davao
13. we have been living together as husband and wife without the
benefit of marriage for more than five (5) years, since September 25,
2003, to date;
14. with our relationship, we have been blessed with three (3) children:

15. we are of majority age, not related to each other, either by affinity
or by consanguinity and there is no legal impediment between us to
marry each other; and

LEMUEL C. ESQUIBEL JANETH S. SASTRILLO

Affiant Affiant

affidavit.
_______________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, MANUEL RICHARD S. FLORIDA and HERMINIA BARCELO SIBUNGA, both of

legal age, Filipino, married and residents of Quezon Boulevard and Buhangin, Davao City,
and state that:
26. That we personally know the person of CATHERINE MADRIÑAN who is

the child of spouses Wenceslao Cacao Madriñan and Florentina Afable Ariston
who was born on December 25, 1965 in Davao City;
27. That her marriage with Nemesio Valeroso was registered at the Civil Registrar of
Davao City, however in the Marriage Contract/Record, the family name of Catherine’s
mother was incorrectly registered as MIRANDA. It should have been MADRIÑAN to
conform with the family name of Catherine’s father;
28. That furthermore, in the same marriage record/contract, Catherine’s date of birth
was likewise erroneously indicated as DECEMBER 25, 1963. It should have been
DECEMBER 25, 1965 to conform with her date of birth as could be gleaned in her
Certificate of Live Birth;
good friends for a long time with Catherine Ariston Madriñan;
interest of whatsoever with Catherine Ariston Madriñan;

MANUEL RICHARD S. FLORIDA AMERICUS S. YANONG

Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2016.
x-------------------------/
Affidavit Of Delayed Registration
I, ERLINDA PEPITO VAN GUNSTEREN, of legal age, Filipino, married,

and a resident of BRC, Catalunan Pequeno, Davao City, Philippines, under oath,
depose and say:
5. That I am legally married to MARINUS JOHANES

JOHANNES VAN GUNSTEREN. Our marriage was
solemnized on March 20, 1996 in Rotterdam, Netherland;
6. That however, I have inadvertently failed to register our marriage

at the Philippine Embassy in Netherland;
7. That I failed to register our marriage because I thought that it has

to be registered only in the Netherland where our marriage took
place;

concerned, particularly to the Department of Foreign Affairs, Davao
City Office in support of my delayed registration of marriage.

ERLINDA P. VAN GUNSTEREN

Affiant

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, MANUEL RICHARD S. FLORIDA and BERNARDO SOLO, both of legal age,
Filipino, married and residents of Quezon Boulevard and Green Meadows Subd., Brgy.
Sto.Niño, Tugbok District, Davao City, Philippines, respectively, after having been sworn to in
32. That we personally know the spouses MARTINUS JOHANNES and

ERLINDA PEPITO;
33. That they were married in Rotterdam, Nederland on May 20, 1996;
good friends for a long time with Erlinda Pepito;


Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2016.
x-------------------------/
Affidavit Of Sponsorship
I, MADAN LAL, of legal age, Filipino, married, Indian National and a

resident of 4B Dau St., Juna Subd., Matina, Davao City, Philippines, under oath,
depose and say:
9. That I am a businessman operating an Indian Grocery operating at

Bajada, Davao City;
10. That I have invited my first cousin CHAWLA SUKHDEV who

is engaged in agriculture and hales from Chak Khurd Punjab,
India;
11.That I am sponsoring him and during his stay in the Philippines, I

will be financially support him;
12. That I hereby guarantee that Chawla Sukhdev will not be a

burden to the Philippine Government;

concerned, particularly to the Philippine Embassy in New Delhi,
India for whatever purpose this may served to my invitation for my
cousin Chawla Sukhdev.

MADAN LAL
Affiant
Witnesses:
SUCHA SINGH & RAM LUBHAYA

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
x-------------------/
Affidavit
I, JOYCE ANN LIBRADO BATULA, 20 years of age, Filipino, single and a

resident of Blk. 9, Lot 6, SIR New Matina, Davao City, Philippines, after having been
1. That I was elected as SK Chairman of Barangay 6-A, San Pedro

Extension, Davao City;
2. That being an SK Chairman, I am a barangay official but I am

not employed in the Government;
3. That during my term of office, from November 30, 1010 to

November 30, 2013, I did not receive salary or any
compensation other than the honorarium for holding in an ex-
oficio capacity;
4. That I am executing this affidavit to attest the truth of the foregoing

averments and to submit the same to the Civil Service Commission for
whatever purpose this may serve to my intent to avail barangay official
privilege

___________________, in the City of Davao, Philippines.
JOYCE ANN L. BATULA

Affiant
SUBSCRIBED AND SWORN to before me this ____________________, in the City of

Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am
satisfied that the affiant understood and voluntarily executed the foregoing affidavit.
________________________________________
x-------------------/
Joint Affidavit
Of Two Disinterested Persons
We, EDDIE MILABO EMBANG, of legal age, Filipino, married and a resident
of Delapitan, Matalam, Cotabato, Philippines, after having been duly sworn to in
5. That I am legally married to LILIA EMELITA LAWA PANDAMON. Our

marriage was solemnized on May 26, 1997 at the Office of the Regional
Circuit Court of Malungon, Sarangani;
6. That prior to our marriage, my wife was still a minor when we cohabited
with each other, that is, living as husband and wife without the benefit of
marriage;
7. That with our relationship, my wife was already eighteen (18) years old
when we were blessed with a child. Being born on February 8, 1997, out
of wedlock, our daughter was an illegitimate child. Therefore, our
daughter was registered as: CHERELLE PANDAMON;
8. That however, after marriage we registered our daughter as CHERELLE

PANDAMON EMBANG. As such, in her succeeding personal documents,
particularly in her Baptismal record, Voter’s ID and school records, her
name registered is Cherelle Pandamon Embang;
9. That I hereby declare under oath that Cherelle Pandamon per

Certificate of Live Birth and Cherelle Pandamon Embang in all other
personal records, refer to one and the same person referring to my
daughter Cherelle Pandamon Embang;
10. That unfortunately, sometime in 1997 my wife left for Manila without
any communication and, to date, her whereabouts could not be
ascertained;
averments and to submit the same to the authorities concerned for
whatever purpose this may serve.

EDDIE M. EMBANG
Affiant

________________________________________

x-------------------/
Affidavit Of Legitimation
I, EDDIE MILABO EMBANG, of legal age, Filipino, married and a resident of

Delapitan, Matalam, Cotabato, Philippines, after having been duly sworn to in
12. That I am legally married to LILIA EMELITA LAWA PANDAMON.

Our marriage was solemnized on May 26, 1997 at the Office of the
Regional Circuit Court of Malungon, Sarangani;
13. That prior to our marriage, my wife was still a minor when we
cohabited with each other, that is, living as husband and wife without the
benefit of marriage;
14. That with our relationship, my wife was already eighteen (18) years
old when we were blessed with a child. Being born on February 8, 1997,
out of wedlock, our daughter was an illegitimate child. Therefore, our
daughter was registered as: CHERELLE PANDAMON;
15. That however, after marriage we registered our daughter as

CHERELLE PANDAMON EMBANG. As such, in her succeeding personal
documents, particularly in her Baptismal record, Voter’s ID and school
records, her name registered is Cherelle Pandamon Embang;
16. That I hereby declare under oath that Cherelle Pandamon per
Certificate of Live Birth and Cherelle Pandamon Embang in all other
personal records, refer to one and the same person referring to my
daughter Cherelle Pandamon Embang;
17. That unfortunately, sometime in 1997 my wife left for Manila without
any communication and, to date, her whereabouts could not be
ascertained;

EDDIE M. EMBANG
Affiant

________________________________________

x--------------------------/
Affidavit Of Accident
With Undertaking
I, REY MANOS ESTORION, of legal Zone 1, B-5, Bago1400ng Buhay

Village, Agdao, Davao City, Philippines, after having been duly sworn to in
30. That I am a holder of Professional Driver License No. LO2-

0___________________ issued by the Land Transportation Office,
Davao City;
31. That at about 4:40 in the afternoon of January 1, 2016, I was

driving a driving a motor vehicle, ISUZU passenger van bearing
Plate No. LFY781, at Ma-a Diversion Road, fronting BDO, when it
figured a vehicular accident;
32. That my driven van bumped a Suzuki passenger jeepney with

Plate No. LWV 175 driven by Abel Reoyan Y Ambala;
33. That as a result thereof, one of the four passengers of the said
Suzuki jeepney, Lydia Yu Marem sustained injuries and, up to this
date, is still confined at the Davao Medical School Foundation
Hospital;
34. That I hereby undertake to shoulder all the medical expenses that
will be incurred by the victim and to attend to the needs of the
patient during her confinement;

foregoing averments purposely to submit the same to the
authorities concerned, for whatever purpowe this may serve.

ROMEO L.CANO, JR.

Affiant
SUBSCRIBED AND SWORN to before me this
___________________________, in the City of Davao, Philippines, and I HEREBY
CERTIFY that I have examined the affiant and that I am satisfied that the
affiant voluntarily executed and understood the foregoing.
________________________________________

x--------------------------/
Joint Affidavit
Of Two Disinterested Persons
We, JOSE BALURAN and CECILLE COSTAN, both of legal age, Filipino,
married and residents of Marang St., Jereza Village, Bajada, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
36. That we personally know the person of MARY ANNE COSTAN;
37. That she is the illegitimate of Floramen Padilla Chua who was born
on August 25, 1980 in Tagum City, Davao del Norte;
38. That we know for a fact that later Floramen Padilla Chua married
Danilo Villamor Romero. As such, being the breadwinner, Floramen
registered her daughter Mary Anne with surname ROMERO in her
early education;
39. That since then, Mary Anne used ROMERO as her surname in her
school records, including other personal records with her
employment and to different agencies, such as the Social Security
System (SSS), Pag-ibig and PhilHealth;
40. That however, when she tried to secure an authenticated

Certificate of Live Birth from the National Statistics Office (NSO),
The result was negative. As such, she filed a late registration of
her birth in Davao City showing that she was born in Davao City;
41. That however, when she tried again to secure Certificate of Live
Birth from the NSO, the result was Certificate of Live Birth filed
sometime in December 11, 1980;
42. That we hereby declare under oath that MARY ANNE CHUA that per
NSO record and MARY ANNE CHUA ROMERO registered in the
Registry of Live Birth in Davao City, refer to one and the same
person, referring to MARY ANNE PADILLA CHUA;
43. That we are executing this affidavit to attest to the truth of the
foregoing averments.

JOSE BALURAN CECILLE COSTAN
Affiant Affiant

CERTIFY that I have examined the affiants and that I am satisfied that they
understood and voluntarily executed the foregoing.
________________________________________

x------------------------/
Joint Affidavit
We, GLORIA VILLA ABRILLE and JOCELYN L. BATULA, both of legal age, Filipino,
married and residents of Green Meadows, Mintal and Madapo Hills, Bankerohan, Davao City,
and state:
16. That we personally know the persons of ROLANDO, JR. D.

ECHAVEZ and KATHRINE C. MELENDREZ;
17. That they had been living together as husband and wife without the
benefit of marriage for more than five (5) years, since Marcdh 19,
2009, up to the present;
18. with their relationship, they had been blessed with a child:
Jheycee Alexander Echavez 4 November 8, 2011
19. That they are of majority age, not related to each other, either by
affinity or by consanguinity and there is no legal impediment between
them to marry each other;

because we have been good neighbors in this city for a long time; and
may serve.

GLORIA VILLA ABRILLE JOCELYN L. BATULA
Affiant Affiant

affidavit.
_______________________________

x--------------------------/
With Undertaking
I, ROMEO CANO Y LARICHE, JR., of legal age, Filipino, married and a

resident of San Vicente, Buhangin, Davao City, Philippines, after having been
44. That I am a holder of Professional Driver License No.

___________________ issued by the Land Transportation Office,
Davao City;
45. That at about 4:40 in the afternoon of January 1, 2016, I was

driving a driving a motor vehicle, ISUZU passenger van bearing
Plate No. LFY781, at Ma-a Diversion Road, fronting BDO, when it
figured a vehicular accident;
46. That my driven van bumped a Suzuki passenger jeepney with

Plate No. LWV 175 driven by Abel Reoyan Y Ambala;
47. That as a result thereof, one of the four passengers of the said
Suzuki jeepney, Lydia Yu Marem sustained injuries and, up to this
date, is still confined at the Davao Medical School Foundation
Hospital;
48. That I hereby undertake to shoulder all the medical expenses that
will be incurred by the victim and to attend to the needs of the
patient during her confinement;

authorities concerned, for whatever purpowe this may serve.

ROMEO L.CANO, JR.
Affiant

________________________________________
Republic of the Philippines )

In the City of Davao ) ss
x--------------------/
Affidavit Of Acknowledgment
And Consent
I, RODEL PORQUEZ BOBADILLA, of legal age, Filipino, single and a resident of

Brgy.Extension, Wao, Lanao del Sur, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and say:
1. That I am the natural and biological father of VIOLA MAE ADLAWAN

BOBADILLA who was born on September 4, 2008 in Maramag, Bukidnon;
2. That my child was born out of wedlock and her mother is MAE ANN BAGAYAS
ADLAWAN;
3. That I hereby declare under oath and acknowledge that VIOLA MAE
ADLAWAN BOBADILLA is my natural and biological daughter and likewise, I
also give my consent for her to use my surname;
4. That my daughter’s mother Mae Ann B. Adlawan is intending to travel abroad

with my daughter Viola Mae which I also give my consent. As such, I hereby give
her my consent to secure Philippine passport for my daughter;
5. That I am executing this affidavit with my own free will and volition attesting the
truth of the foregoing averments purposely to inform the authorities concerned,
particularly the Department of Foreign Affairs (DFA), for whatever legal purpose
this may serve.
IN WITNESS HEREOF, I have hereunto affixed my signature this

________________________ at Davao City, Philippines.
RODEL P. BOBADILLA
Affiant
SUBSCRIBED AND SWORN to before me this ________________ in the City of
satisfied that he understood and voluntarily executed the foregoing affidavit.

x-------------------------/
Affidavit Of Support
I, RONALD VILLANUEVA JOSE, of legal age, Filipino, married and a

resident of Purok 35, Maharlika Village, Brgy.Ma-a, Davao City, Philippines,
14. That I am employed as security guard of Dasia;
15. That I am the only bread winner of the family my wife being not
employed;
16. That I am supporting my wife and my two (2)-year old child,

ANECHECCA NUÑEZ JOSE;

concerned, particularly to my employer DASIA purposely to
acquire ATM Card.

RONALD V. JOSE
Affiant

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit Of Loss
I, JESUS SEGARA SALAS, of legal age, Filipino, married and a resident
of Jerome St., Agdao, Davao City, Philippines, after having been duly sworn to in
50. That I am an owner of a duly licensed 45 caliber Para Ordinance

pistol with Serial No. HM62273;
51. That on or about August 1, 2014, at around 12:00 noon, I parked

my Ford Ranger pick-up bearing Plate No. LGJ 478 at Aparente
St. corner Blk. 6,BCH, General Santos City, purposely to buy
some food at a nearby store. Thereafter, as a I returned to my
truck, I discovered that my said 45 caliber pistol was missing;
52. That upon investigation, I discovered that the right side widow
was opened;
53. That diligent efforts exerted to locate my missing gun proved to

no avail;
54. That under oath, I hereby declare that the lost gun was not sold
or in any manner alienated to other persons;

concerned of the Philippine National Police for whatever
purpose this may serve.
IN WITNESS hereof, I have hereunto affixed my signature this December
21, 2015, in the City of Davao, Philippines.
JESUS S. SALAS
Affiant
SUBSCRIBED AND SWORN to before me this December 21, 2015 in the

the foregoing.
_______________________________

x------------------------/
Joint Affidavit
We, GLORIA VILLA ABRILLE and JOCELYN L. BATULA, both of legal age, Filipino,
married and residents of Green Meadows, Mintal and Madapo Hills, Bankerohan, Davao City,
and state:
22. That we personally know the persons of ROLANDO, JR. D.

ECHAVEZ and KATHRINE C. MELENDREZ;
23. That they had been living together as husband and wife without the
benefit of marriage for more than five (5) years, since Marcdh 19,
24. with their relationship, they had been blessed with a child:
Jheycee Alexander Echavez 4 November 8, 2011
25. That they are of majority age, not related to each other, either by
affinity or by consanguinity and there is no legal impediment between
them to marry each other;

because we have been good neighbors in this city for a long time; and
may serve.

GLORIA VILLA ABRILLE JOCELYN L. BATULA

Affiant Affiant

affidavit.
_______________________________

x------------------------/
Joint Affidavit
We, MARIA THERESA J. DUMAGAN and CELEDONIO A. CALIVOSO, both of

legal age, Filipino, single and residents of Abayon Village and Durian Village, Calinan,
Davao City, Philippines, respectively, after having been sworn to in accordance with law
28. we personally know the persons of Lemuel Castro Esquibel

and Janeth Saron Sastrillo;
29. they had been living together as husband and wife without the
30. with their relationship, they had been blessed with three (3)
children:

31. they are of majority age, not related to each other, either by affinity
or by consanguinity and there is no legal impediment between them to
marry each other;

because we have been good neighbors in our place of residence for a
long time; and
may serve.

MARIA THERESA J. DUMAGAN CELEDONIO A. CALIVOSO

Affiant Affiant

affidavit.
_______________________________

x------------------------/
Joint Affidavit
(Cohabitation)
We, LEMUEL CASTRO ESQUIBEL and JANETH SARON SASTRILLO, both 34

years old, Filipino, single and residents of Purok 38 Abayon Village, Calinan, Davao
34. we have been living together as husband and wife without the
2003, to date;
35. with our relationship, we have been blessed with three (3) children:

36. we are of majority age, not related to each other, either by affinity
or by consanguinity and there is no legal impediment between us to
marry each other; and

LEMUEL C. ESQUIBEL JANETH S. SASTRILLO

Affiant Affiant

affidavit.
_______________________________

x-------------------/
Affidavit of Waiver
I, MATILDE ALCOVER VDA. DE BASAN, of legal age, Filipino, widow and a

resident of Orchid St., Malinawon Village, Matina Aplaya, Davao City, after having been
1. That I am a lawful occupant/possessor of a residential lot situated at

Malinawon Village, Matina Aplaya, Davao City, the same being a
project of Mindanao Realty Corporation;
2. That in the said lot, a house improvement made of concrete materials

was introduced by my son ARNULFO ALCOVER BASAN;
3. That I hereby WAIVE my right, share, participation and interest in the

aforesaid residential lot unto and in favor of my said son;
4. That I hereby declare that the said property exclusively belongs to my

son, ARNULFO ALCOVER BASAN;
averments, purposely to submit the same to the Mindanao Realty
Corporation for the aforementioned purpose of waiving my right and
interest.
IN WITNESS WHEREOF, we have hereunto set our hands this

_________________________, at the City of Davao, Philippines.
MATILDE A. BASAN
Affiant
SUBSCRIBED AND SWORN to before me this ________________________, in

the City of Davao, Philippines and I further certify that I have personally examined the
affiant and I am satisfied that she understood and voluntarily executed the foregoing
affidavit.

x------------------------/
Joint Affidavit
We, WINSTON A. NACARIO and RICHARD F. NACARIO, of legal age,
Filipino, married and residents of Lot 9, Blk.9 Riverview Village, Bacaca Rd. and
Sulpicio Compound, Sasa, Davao City, Philippines, respectively, after having
been sworn to in accordance with law do hereby depose and state that:
37. I, WINSTON A. NACARIO, am the brother of ROMEO A.

NACARIO, JR. while I, RICHARD F. NACARIO, am his cousin;
38. That we know for a fact that Romeo A. Nacario, Jr. and
Jenneth S. Montefalcon have been living as husband and wife,
without the benefit of marriage, since June 15, 2007 up to the
present;
39. That out of their relationship, they begot a child: RANJHAYE

MARGARETTE M. NACARIO born on May 3, 2008;
40. That we have personal knowledge of the facts above because

being Filipinos, we are closely knit family and we know almost all
circumstances of our relatives;
41. That we are executing this affidavit with our own free act, free
from intimidation of whatsoever, and to submit the same to the
authorities concerned for whatever purpose this may serve.

_________________, in the City of Davao, Philippines.
WINSTON A. NACARIO RICHARD F. NACARIO

Affiant Affiant
Valid ID _______________ Valid ID ________________
SUBSCRIBED AND SWORN TO before me this

_______________________, in the City of Davao, Philippines, and I HEREBY
CERTIFY that I have examined the affiants and that I am satisfied that they
understood and voluntarily executed the foregoing affidavit.
_________________________________
Doc.No.____________;
Page No.___________;
Book No. ___________;
Series of 2015.

x - - - - - - - - - - - - - - - - - - - - - - - - -/
I, NILDA MAGBUTAY GALON, of legal age, Filipino, married and a
resident of Davao City, Philippines, after having been duly sworn to in
56. That sometime in 2001, I requested an authenticated copy

of my Certificate of Live Birth at the National Statistics
Office (NSO). However, per verification from the said office,
my birth record is not available;
57. That as such, per advise from the NSO, I filed for late
registration of my birth at the office of the Local Civil
Registrar of Davai City;
58. That after the late registration, I requested a copy of my

certificate of live birth at the NSO. However, instead of the
copy of the late registration of my Birth Certificate which I
recently filed, another copy filed sometime in November 24,
1976 by a ‘hilot’ came out; photocopy of the said Certificate
of Live Birth filed sometime in November 24, 1976 is hereto
attached to form integral part of this affidavit;
59. That in the said Birth Certificate filed sometime in

November 24, 1976, my given name and family name were
erroneously registered as NIDA MAGBOTAY. It should
have been NILDA MAGBUTAY to conform with my true
and correct given name and family name,
LIKEWISE, in the same certificate, the date of birth of Nilda

Magbutay was incorrectly registered as Nov.2, 1976. It
should have been Nov. 1, 1976;
photocopies of my Baptismal Certificate and Certificate of

Marriage are hereto attached forming integral parts hereof;
~ more ~
~ page 2 ~
60. That NIDA MAGBOTAY. per Birth Certificate dated

November 24, 1976 and NILDA MAGBUTAY per
Baptismal Certificate and Certificate of Marriage, refer to
one and the same person, referring to the undersigned
whose true name is NILDA SAYSON MAGBUTAY, now
Mrs. NILDA MAGBUTAY GALON;
61. That I am executing this affidavit to qattesat to the truth of

the foregoing averments and to submit the same to the

__________________________, in the City of Davao, Philippines.
NILDA M. GALON
Affiant

_____________________ in the City of Davao, Philippines, and I HEREBY
________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ALBERTO A. MALINAO and ROLANDO N. SOLO, both of legal age, Filipino,
married and residents of Rosalina III, Baliok, Talomo District, Davao City, Philippines,
that:
36. That we personally know the person of Amalia Lobaton Esteves who
is the child of Alicia Lobaton Esteves;
37. That Amalia Lobaton Esteves died on October 27, 2015 in Brokenshire Hospital,
Davao City. In her Certificate of Death however, her mother’s name was incorrectly
registered as Alice Araña. It should have been Alicia Lobaton Esteves, to conform
with her mother’s true and corrct name as could be gleaned in her record with the
Social Security System (SSS); that the family name ARAÑA is her mother’s maiden
middle name;
38. That Alice Araña, mother of Amalia Lobaton Esteves per Certificate of Death and
Alicia Lobaton Esteves, our neighbor, refer to one and the same person, referring to
the mother of Amalia Lobaton Esteves whose true and correct name Alicia Lobaton
Esteves;
good neighbors for a long time in this city with the Esteves family;
interest of whatever with the deceased;

ALBERTO A. MALINAO ROLANDO N. SOLO

Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit Of Loss
I, IBRAHIM MARK M.HANDI, of legal age, Filipino, married and with
address at c/o Coast Guard District, Southwestern Mindanao, Zamboanga City,
Philippines, after having been duly sworn to in accordance with law, do hereby
depose and say:
62. That I am an enlisted personnel of the Philippine Coast Guard;
63. That as such, I am a member of the PNSLAI and being a

member, was issued a PNSLAI PASSBOOK;
64. That sometime in October, 2015, when I came to Davao City for
MARSAD schooling, I discovered the loss of my said Passbook;
65. That diligent efforts exerted to locate the lost Passbook proved
to no avail;
66. That the lost Passbook was not made a collateral for a loan or in
any manner encumbered to any person or third party;
67. That I hereby undertake to return or surrender the lost Passbook

should in the future the same be found;

foregoing averments and to submit the same to the PNSLAI
purposely to request for a new PNSLAI Passbook in lieu of the
lost one.
IN WITNESS hereof, I have hereunto affixed my signature this November

IBRAHIM MARK M.HANDI

Affiant
SUBSCRIBED AND SWORN to before me this November 26, 2015 in the

affiant and that I am satisfied that the affiant understood andvoluntarily executed
the foregoing.
__________________________________

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit
depose and say:
69. That I am a Seaman First Class enlisted personnel of the

Philippine Coast Guard;
70. That I am now in Davao City to attend SCHOOLING MARSAD

at Coast Guard District Eastern Mindanao situated at Sasa,
Davao City;
71. That on or about November 23, 2015, at about noon time, my

superior officer, CPO Tabor PCG called by cellular phone
informing me that one of our junior enlisted personnel, Seaman
2nd Ramirez, who has been discharge from the service, when
conducted an investigation put all the blame to me for his failure
to report;
72. That Seaman 2nd Ramirez further alleged that I have sent him
text messages warning him not to report for duty because of his
wrong doings and that allegedly I informed him that his acts
were caught by our CCTV;
73. That I vehemently deny that malicious allegations of Seaman 2 nd

Ramirez because I have never sent him any text message after
he left the unit to take his R & R;

foregoing averments purposely to submit the same to our
mother unit, Coast Guard District, Southwestern Mindanao,
Zamboanga City, to controvert the malicious imputation of
Seaman 2nd Ramirez.


Affiant

affiant and that I am satisfied that the affiant voluntarily executed and understood
the foregoing.
__________________________________

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit
I, ESTELITA OQUINA DANIEL, 59 years of age, Filipino, married and a
resident of Maharlika Village, Matina Aplaya, Brgy. 75-A, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose and
say:
75. That my daughter,Mary Jean Patayon Takiguchi, who was

married to a Japanese national and is now in Japan;
76. That my daughter invited me to visit her in Japan and as such, I

intend to acquire visiting relative visa at the Japanese Embassy,
Manila;
77. That however, one of the requirement is my school record which

unfortunately I could not comply for reason that I have not gone
to school;

concerned, particularly to the Japanese Embassy, Manila, for
whatever purpose this may serve to my application to possess
Visiting Relative Visa.

_________________________, in the City of Davao, Philippines.
ESTELITA O. DANIEL
Affiant
SUBSCRIBED AND SWORN to before me this ______________________

the affiant and that I am satisfied that the affiant voluntarily executed and
understood the foregoing.
__________________________________
Doc.No. _______
Page No._______
Book No. _______
Series of 2015.

x - - - - - - - - - - - - - - - - - - - - - - - - -/
Affidavit
depose and say:
79. That I am a Seaman First Class enlisted personnel of the

Philippine Coast Guard;
80. That I am now in Davao City to attend SCHOOLING MARSAD

at Coast Guard District Eastern Mindanao situated at Sasa,
Davao City;
81. That on or about November 23, 2015, at about noon time, my

superior officer, CPO Tabor PCG called by cellular phone
informing me that one of our junior enlisted personnel, Seaman
2nd Ramirez, who has been discharge from the service, when
conducted an investigation put all the blame to me for his failure
to report;
82. That Seaman 2nd Ramirez further alleged that I have sent him
text messages warning him not to report for duty because of his
wrong doings and that allegedly I informed him that his acts
were caught by our CCTV;
83. That I vehemently deny that malicious allegations of Seaman 2 nd

Ramirez because I have never sent him any text message after
he left the unit to take his R & R;

foregoing averments purposely to submit the same to our
mother unit, Coast Guard District, Southwestern Mindanao,
Zamboanga City, to controvert the malicious imputation of
Seaman 2nd Ramirez.


Affiant

affiant and that I am satisfied that the affiant voluntarily executed and understood
the foregoing.
__________________________________
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ALBERTO A. MALINAO and ROLANDO N. SOLO, both of legal age, Filipino,
married and residents of Rosalina III, Baliok, Talomo District, Davao City, Philippines,
that:
42. That we personally know the persons of spouses Armando Lezon

Fenequito (deceased) and Judeth Barlizo Miguel;
43. That they were married on September 26, 2004 under the civil rites solemnized by
the Hon. Presiding Judge Ridgway M. Tanguili at the Regional Trial Court, Branch 15,
Davao City;
44. That we both have personal knowledge of the facts above because we were
present during the nuptial ceremony;

ALBERTO A. MALINAO ROLANDO N. SOLO

Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.
x--------------------------/
I, BONIE DIONZON BRAVO, of legal age, Filipino, married and a resident

of San Francisco Village, ABSCN, Matina, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and say:
85. That I am a holder of Professional Driver License No. D04-01-

171110 issued by the Land Transportation Office, Taguig City,
Metro Manila and employed as driver of Emilio I. Dizor;
86. That on or about November 15, 2015, at around 12:30 in the

afternoon, while driving the truck of my employer, a ISUZU WING
VAN with PLATE NO. MV1972, at McArthur Highway, Ulas, this city,
a flying stone hit left side of the wind shield of my driven vehicle;
87. That as result thereof, the said portion of the wind shield cracked;

authorities concerned, for purposes of insurance.

BONIE D. BRAVO
Affiant

________________________________________
Doc.No.__________
Page No. _________
Book No. _________
Series of 2015.
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
46. That we personally know the persons of ALMA PARAN CARLON;
47. That she died on January 17, 2014 at home in Sunrise Village, km. 14, Panacan,
Davao City;
48. That her death was registered however the date of death was incorrectly
registered as 18 JANUARY 2014. It should have been 17 JANUARY
2014;


Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.
x------------------------/
Joint Affidavit
(Cohabitation)
We, ERIC JOSEPH ALBANO PERIN and JASMIN RIGEL SOMOSA SADAO, 29 and
33 years old, Filipino, single and residents of Blk.23, Lot 32 Main Road, Doña Village, Phase 2,
Matina, Davao City, Philippines, respectively, after having been sworn to in accordance with law
42. we have been living together as husband and wife without the benefit of
marriage for more than five (5) years, since December 16, 2008, to date;

consanguinity
3. there is no legal impediment between us to marry each other;
4. That we are executing this affidavit with our own free act and to submit the
same to the authorities concerned for whatever purpose this may serve to our
intent to marry each other in accordance with Article 34 of the New Civil Code
of the Philippines.
IN WITNESS hereof, we have hereunto affixed our signatures this 6 th day of September,
2012, in the City of Davao, Philippines.
ERIC JOSEPH A. PERIN JASMIN RIGEL S. SADAO

Affiant Affiant
Corroboration
We, AMERICUS S. YANONG and YOLANDO C. ENATE, both of legal age, Filipino,
single/married and residents of Matina and Toril, Davao City, Philippines, respectively, after
having been sworn to in accordance with law do hereby depose and state:
1. That the statements above made by the affiant are true and correct to the best
of our knowledge, information and belief;
2. That we both have personal knowledge of the facts above because we have
been good friends for a long time;
3. That we are executing this affidavit to attest to the truth of the foregoing
facts.

_______________________, in the City of Davao, Philippines.
AMERICUS S. YANONG YOLANDO C. ENATE

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this _______________________, in the City

of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am
satisfied that they voluntarily executed and understood the foregoing affidavit.
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
51. That we personally know the persons of LORENA PARAN CARLON;
52. That she is the child of spouses Alma Lariosa Paran and
Locrecio Polinar Paran who wasborn on August 29, 1984 in Davao
City;
53. That however, in her Certificate of Live Birth her middle name was incorrectly
registered as POLINAR. The middle name of her father. It should have been
PARAN to conform with the family nameof her mother;
54. That Lorena Polinar Carlon, per Certificate of Live Birth and Lorena
Paran Carlon, our neighbor, refer to one and the same whose true and correct
middle name is PARAN;
friends for a long time;


Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, MANUEL RICHARD S. FLORIDA and AMERICUS S. YANONG, both of legal age,
1. That we personally know the persons of VENUS MACAHIG FLORES and

FLORENCIO MACAHIG SANICO, JR.
2. That the duo are half sister and brother being, Venus Macahig Flores, daughter of Arcenta
Macahig with Recardo Flores and Florencio Macahig Sanico, Jr., son of Arcenta Macahig with
Florencio Sanico, Sr.;
3. That however, in the Certificate of Live Birth of Venus Macahig Flores, her mother’s GIVEN
name was erroneously registered as Acenta. It should have been Arcenta to
conform with her true and correct given name;
4. That Acenta Macahig, mother of Venus Macahig Flores and Arcenta

Macahig, mother of Florencio Macahig Sanico, Jr., refer to one and the same whose
true and correct name is ARCENTA MACAHIG;
5. That we both have personal knowledge of the facts above because we have been good friends
with the Macahig/Sanico family;


Affiant Affiant

_________________________________________
Doc. No. _________;
Page No._________;
Book No. _________;
Series of 2015.

x--------------------------/
I, ISAGANI SASAM PARRA, of legal age, Filipino, married and a resident

of Purok 13, km.14, Panacan, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and say:
89. That I am a holder of Non-Professional Driver License No. LO3-99-

035916 issued by the Land Transportation Office, Davao City, and
employed as driver of Egres G.Cruz;
90. That on or about August 5, 2015, at around 7:30 in the morning,

while maneuvering the motor vehicle of my employer, a TOYOTA
HI-LUX PICK-UP with PLATE NO. AAH 4107, inside the garage in
Panacan, the FRONT and REAR BUMPER of the said vehicle hit the
gate;
91. That as result thereof, the front and rear bumper incurred
damages;

authorities concerned, for purposes of insurance.

ISAGANI S. PARRA
Affiant

________________________________________
Doc.No.__________
Page No. _________
Book No. _________
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, MANUEL RICHARD S. FLORIDA and AMERICUS S. YANONG, both of legal age,
7. That we personally know the persons of VENUS MACAHIG FLORES and

FLORENCIO MACAHIG SANICO, JR.
8. That the duo are half sister and brother being, Venus Macahig Flores, daughter of Arcenta
Macahig with Recardo Flores and Florencio Macahig Sanico, Jr., son of Arcenta Macahig with
Florencio Sanico, Sr.;
9. That however, in the Certificate of Live Birth of Venus Macahig Flores, her mother’s GIVEN
name was erroneously registered as Acenta. It should have been Arcenta to
conform with her true and correct given name;
10. That Acenta Macahig, mother of Venus Macahig Flores and Arcenta
Macahig, mother of Florencio Macahig Sanico, Jr., refer to one and the same whose
true and correct name is ARCENTA MACAHIG;
friends with the Macahig/Sanico family;


Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x-------------------/
A f f i d a v i t
I, AMERICUS SOTTO YANONG, of legal age, Filipino, married and a resident of

Mahogany St., Green Meadows Subd., Tugbok District, Davao City, Philippines, after having
1. That I have retired from government service last August 14, 2015,
particularly from the Office of the City Prosecutor, Department of Justice;
2. That I was at my sixty fifth (65th) when I retired;
3. That to date, I am not employed;
4. That I am executing this affidavit to attest to the truth of the foregoing facts
and to submit the same to the authorities concerned for whatever purpose
this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of November, 2015
at the City of Davao, Philippines.
AMERICUS S. YANONG
Affiant
SUBSCRIBED AND SWORN to before me this 13 th of November, 2015, in the City of

satisfied that he voluntarily executed and understood the foregoing affidavit.
________________________________________
x-------------------/
Affidavit Of Undertaking
I, ALLAN LEE MACASINDIL, of legal age, Filipino, married and a resident of Door 5,
Purok 26, Muslim Village, Matina, Davao City, Philippines, after having been duly sworn to in
1. That I am an owner of a residential house, my given address first mentioned

above;
2. That the light connection was cut-off because of non-payment of electric Bill;
3. That without delay, I cause the payment of the bill but as the facility was
about to be reconnected, it was discovered that the facility was already
reconnected by one of the borders, hence this affidavit;
4. That the reconnection was not deliberately done by the undersigned but by
one of the borders;
5. That I hereby undertake to forbid my borders not to reconnect electric facility

if in case the same was cut-off by DLPC personnels
and to submit the same to the DLPC for whatever this may serve to our
intent to apply for reconnection of our electric facility.
IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of October, 2015 at
ALLAN L. MACASINDIL
Affiant
SUBSCRIBED AND SWORN to before me this 8th of October, 2015, in the City of Davao,
Philippines and I further certify that I have personally examined the affiant and I am satisfied
that he voluntarily executed and understood the foregoing affidavit.
________________________________________
x-------------------/

above;
one of the borders;

ALLAN L. MACASINDIL
Affiant
________________________________________

x------------------------/
JOINT AFFIDAVIT
We, AMERICUS S. YANONG and VIRGIE C. TAFORCO, both of legal age,

Filipino, married and residents of Blk. 35, Lot 38 , Buttercup St., Green Meadows Subd.,
Brgy. Sto. Niño, Tugbok District and Rosalina lll, Baliok, Talomo District, Davao City,
Philippines, respectively, after having been sworn to in accordance with law do hereby
depose and state that:
13. That we personally know the person of JUDITH MIGUEL
FENEQUITO who is wifeof the late Armando Leyson Fenequito;
14. That she is same Judith Berlizo Miguel who is the Fifth (5th) of the
eleven (11) children of spouses Johnny Inalin Miguel and Rosita Bagay
Berlizo;
15. That she was born on October 10, 19066 in General Santos City;
16. That we both have personal knowledge of the facts above because
we have been good friends with Judith Miguel Fenequito for a long time in
this city;
17. That we are executing this affidavit to attest the truth of the foregoing
averments.

AMERICUS S. YANONG VIRGIE C. TAFORCO

Affiant Affiant
SUBSCRIBED AND SWORN to before me this ____________________ in the

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiants
and that I am satisfied that they executed voluntarily and understood the foregoing
affidavit.
__________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x--------------------------/
I, AURELIO JR. ALOLOD PARCON, of legal age, Filipino, married and a

resident of km. 9, No.9 Ulas, Catalunan Pequeño, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and say:
93. That I am a holder of Non-Professional Driver License No. MOI-87-

015473 issued by the Land Transportation Office, Davao City;
94. That on or about October 29, 2015, at around 7:30 in the morning,
while maneuvering the utility vehicle of my brother JOEL A.PACON,
an ISUZU HI-LANDER with PLATE NO. LFE 962, inside our garage,
the RIGHT FRONT DOOR hit a 2 x 2 lumber which was on pile;
95. That as result thereof, the right front door incurred damage, dent
and scratch;

authorities concerned, particularly to the La Perla Insurance, for
IN WITNESS hereof, I have hereunto affixed my signature this 11 th day of

November, 2015, in the City of Davao, Philippines.
AURELIO JR. A. PARCON

Affiant
SUBSCRIBED AND SWORN to before me this 11th day of November, 2015,

________________________________________
Doc.No.__________
Page No. _________
Book No. _________
Series of 2015.

x--------------------------/
Affidavit/Waiver
I, ROMMEL T. GEYROZAGA, of legal age, Filipino and a resident of

Davao City, Philippines, after having been duly sworn to in accordance with
law, do hereby depose and say:
97. That I am the representative of BPI Family Savings Bank (BPI) with
head office address at Makati City;
98. That BPI is the registered owner of a Honda City sedan bearing
Plate No. HBD 895;
99. That at around 7:00 o’clock in the morning of November 3, 2015,

while the above-described company car was parked unattended at
the Bacaca Road, Bajada, particularly at the vicinity of AIMISHI
Bldg. when a neighbor watering her plants accidentally hit the
front hood of her hose;
100. That as a result thereof, the hood of the company car incurred
minor damage (scratches) estimated to cost SIX THOUSAND
PESOS (Php=6,000.00);
101. That the incident was amicably settled and the respondent Mr.
Dindo Bel, Sr. agreed to pay the damaged incurred;
102. That I hereby acknowledge receipt of the Php=6,000.00 paid by

Mr. Bel;
103. That I am executing this affidavit with my own free will, free
from intimidation, attesting the truth of the foregoing averments
purposely to submit the same to the authorities concerned for
IN WITNESS hereof, I have hereunto affixed my signature this 6 st day of

October, 2015, in the City of Davao, Philippines.
ROMMEL T. GEYROZAGA
Affiant
SUBSCRIBED AND SWORN to before me this 6 th day of October, 2015, in

the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined
________________________________________
Doc.No.__________
Page No. _________
Book No. _________
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, VIRGINIA O. DUMALAG and MARICEL C. CADAVEZ, both of legal age, Filipino,
married and residents of Davao City, Philippines, respectively, after having been sworn to in
18. That we personally know the person of GRACE JUDILLA BANUA who is
now residing in New Bataan, Comval Province;
19. That she is named payee of WEALTHBANK CHECK NO. 0011227863

dated October 20, 2015 with a face value of SEVENTEEN
THOUSAND THIRTY FOUR (Php=17,034.00);
20. That her family name in the said check however was erroneously spelled as BANIA. It
should have been BANUA to conform with his true and correct family name as evidenced
by her valid identification card;
21. That GRACE JUDILLA BANUA per WEALTHBANK CHECK NO.

0011227863 dated October 20, 2015 with a face value of SEVENTEEN THOUSAND
THIRTY FOUR (Php=17,034.00) and GRACE JUDILLA BANIA our friend refer
to one and the same whose true and correct family name is BANUA;
friends for several years;

VIRGINIA O. DUMALAG MARICEL C. CADAVEZ

Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x-------------------/
Affidavit of Waiver
We, GILMER A. GASCON and GAYMAR A. GASCON, both of legal age,

Filipino, single/married and residents of Sitio Basak, Mintal, Tugbok District, Davao City,
after having been duly sworn to in accordance with law, do hereby depose and say:
1. That we are among the three children of the late MILA ADLAWAN GASCON
who died on October 26, 2015 at home in Purok 2, Bayyview, km. 11, Sasa,
Davao City;
2. That during the lifetime of the deceased, she was an Overseas Filipino
Worker (OFW);
3. That being an OFW, we are entitled to benefit claims, such as Insurance and
Death Claims;
4. That we hereby waive unto and in favor of our sibling HONEY GRACE
ADLAWAN GASCON and likewise authorize her to collect and receive from
the Office of the Overseas Workers Welfare Administration (OWWA)
whatever proceeds that will be due to us or our mother;
5. That we are executing this affidavit with our own free act, free from
intimidation, and to submit the same to the Office of the Overseas Workers
Welfare Administration for whatever purpose this may serve to our sibling’s
claim of Insurance/Death benefits.
IN WITNESS WHEREOF, we have hereunto set our hands this _____________,

__________________ at the City of Davao, Philippines.
Conformity:
HONEY GRACE A. GASCON GILMER A. GASCON

Affiant Affiant
GAYMAR A. GASCON
Affiant
SUBSCRIBED AND SWORN to before me this ________________________, in

the City of Davao, Philippines and I further certify that I have personally examined the
affiants and that I am satisfied that they voluntarily executed and understood the
Doc. No.______________
Page No. _____________
Book No. _____________
Series of 2015
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, RICHARD S. FLORIDA and BOBBY BALURAN, both of legal age, Filipino, married
and residents of SIR, Matina, Davao City, Philippines, respectively, after having been sworn to
in accordance with law do hereby depose and state that:
24. That we personally know the person of LUCRECIO POLINAR

CARLOM
who is the child of spouses Lucia Polinar and Benito Carlom who was born on March 14,
1958;
25. That he died on November 2, 2015 in Davao City. However, in the Certificate of Death, his
family name was erroneously registered as CARLON. It should have been
CARLOM to conform with his true and correct family name as could be gleaned in his
Certificate of Birth;
FURTHERMORE, in the said Death Certificate, the deceased’s date of birth was also
incorrectly registered as MARCH 15, 1958. It should have been MARCH
14, 2015;
26. That LUCRECIO POLINAR CARLON per Certificate of Death and

LUCRECIO POLINAR CARLOM per Certificate of Birth refer to one and the
same whose true and correct family name is CARLOM and whose correct date of birth is
MARCH 14, 2015
friends during the lifetime of the deceased;

RICHARD S. FLORIDA BOBBY BOROMEO

Affiant Affiant

_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x--------------------------/
Affidavit/Waiver
I, ROMMEL T. GEYROZAGA, of legal age, Filipino and a resident of

104. That I am the representative of BPI Family Savings Bank (BPI)

with head office address at Makati City;
105. That BPI is the registered owner of a Honda City sedan bearing
Plate No. HBD 895;
106. That at around 7:00 o’clock in the morning of November 3,

2015, while the above-described company car was parked
unattended at the Bacaca Road, Bajada, particularly at the vicinity
of AIMISHI Bldg. when a neighbor watering her plants accidentally
hit the front hood of her hose;
107. That as a result thereof, the hood of the company car incurred
minor damage (scratches) estimated to cost SIX THOUSAND
PESOS (Php=6,000.00);
108. That the incident was amicably settled and the respondent Mr.
Dindo Bel, Sr. agreed to pay the damaged incurred;
109. That I hereby acknowledge receipt of the Php=6,000.00 paid by

Mr. Bel;
110. That I am executing this affidavit with my own free will, free
from intimidation, attesting the truth of the foregoing averments
purposely to submit the same to the authorities concerned for

ROMMEL T. GEYROZAGA
Affiant
SUBSCRIBED AND SWORN to before me this 6 th day of October, 2015, in

________________________________________
Doc.No.__________
Page No. _________
Book No. _________
Series of 2015.

x---------------------------/
Affidavit Of Loss
I, FLORDELIZ FERRAZ Y LLAMAS, of legal age, Filipino, widow and a resident

of Blk. 17, Lot 1-A, Monte Maria Subd., Catalunan Grande, Davao City, Philippines,
a) That at around 9:30 a. m. of November 1, 2015, while I was

in Manila and traveling back to Davao City thru Cebu Pacific
Flight No. 51981 when I noticed that my backpack was
slightly opened;
b) That as I inspected my back pack, I discovered the loss of my

red bag with wallet containing the following items:
as such, I was issued ATM Card;
c) That unfortunately, on or about October 10, 2015, at around

11:00 in the evening, my said ATM card was captured at a
Union Bank ATM booth at St. Luke’s Hospital, Quezon City;
d) That my said ATM was not alienated nor sold to any third
party;
e) That I am executing this affidavit to attest the truth of the

Union Bank to request for a replacement of my lost ATM Card.

____________________________ in the City of Davao, Philippines.
DR. MARK ANTHONY A. TOM
Affiant
SUBSCRIBED AND SWORN to before me this _________________________, in the

and that I am satisfied that the affiant voluntarily executed and understood the
foregoing.

x---------------------------/
Affidavit Of Loss
I, FLORDELIZ FERRAZ Y LLAMAS, of legal age, Filipino, widow and a resident
of Blk. 17, Lot 1-A, Monte Maria Subd., Catalunan Grande, Davao City, Philippines,
f) That at around 9:30 a. m. of November 1, 2015, while I was

in Manila and traveling back to Davao City thru Cebu Pacific
Flight No. 51981 when I noticed that my backpack was
slightly opened;
g) That as I inspected my back pack, I discovered the loss of my

red bag with wallet containing the following items:
as such, I was issued ATM Card;
h) That unfortunately, on or about October 10, 2015, at around

11:00 in the evening, my said ATM card was captured at a
Union Bank ATM booth at St. Luke’s Hospital, Quezon City;
i) That my said ATM was not alienated nor sold to any third
party;
j) That I am executing this affidavit to attest the truth of the



Affiant

foregoing.

x---------------------------/
A f f i d a v i t
I, MARVIN PADADA Y BANUA, of legal age, Filipino, single and a resident of

Barangay Bale, Babak, Island Garden City of Samal, Philippines, after having been
1. That I am employed as security guard of Davao Security and

Investigation Agency (DASIA) with office address Damaso Suazo St.,
Davao City;
2. That on or about October 31, 2015, at around 6:00 in the evening,

while on duty at the Ulticom Builders, Inc. construction project at
Barangay Libudan, Babak District, IGACOS, my wife called thru
cellular for emergency reason. She is on her eighth-month family
way. As such, after securing important company tools/.equipments,
using my motorcycle, I sped home to Balet. I returned to my post at
around 3:00 a.m.;
3. That I acknowledge my fault for abandonment of post per

Metroguard, Inc. Memorandum dated November 2, 2015;
4. That I hereby request the Company’s consideration for my fault and

hereby promise to refrain from committing the same offense in the
future;
5. That further, should the same offense be repeated, I understand that

this will mean my dismissal from work with the Company;
6. That I am executing this affidavit with my own free will, free from
intimidation, attesting the truth of the foregoing facts, purposely to
submit the same to the Davao Security and Investigation Agency
(DASIA) for whatever purpose this may serve.

MARVIN B. PADADA
Affiant

foregoing.
________________________________________
Doc. No._________
Page No. ________
Book No._________
Series of 2015.
x-------------------------/
I, KATHRINA GAYLE DELA TORRE LADICA, of legal age, Filipino, single

and a resident of Blk. 8, Lot 23, Buttercup St., Green Meadows Subd., Brgy. Sto.
Niño, Tugbok District, Davao City, Philippines, under oath, depose and say:
18. That I am a registered nurse employed at the Davao Doctors

Hospital, Davao City;
19. That I am supporting my younger sister MARY ANNE D.

LADICA who is 20 years old and still a student at her third year at
Physical Therapy course at Cebu Doctors University, Cebu City;
20. That she is intending to travel to Shanghai, China, as tourist

and that I will be supporting her travel;

concerned for whatever purpose this affidavit may serve to my
sister’s travel to Shanghai, China.
IN WITNESS hereof, I have hereunto affixed my signature this 30th day of

KATHRINA GAYLE D. LADICA

Affiant
SUBSCRIBED AND SWORN TO before me this 30 th day of October, 2015,

Doc.No.____________
Page No.___________
Book No. ___________
Series of 2015.
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, RICHARD S. FLORIDA and GRACE G. CABIGAS, both of legal age, Filipino,
married/single and residents of SIR, Matina, Davao City, Philippines, respectively, after having
29. That we personally know the person of MICHELLE PUERIN

CARBONEL;
30. That she is the youngest of the four children of spouses ANTONIO SERENO
CARBONEL and REMEDIOS ANDO PUEREN who was born on Decedmber17,1987 in
Tagum City, Davao;
31. That her birth was registered at the Office of the Civil Registrar of Tagum City, Davao.
However, her middle name and family name were incorrectly registered as PUERIN and
CARBONEL. They should have been PUEREN and CARBONELL to
conform with the true and correct middle and family name of their family as could be gleaned in
the NSO authenticate Certificate of Live Birth of her elder sister EMILY
PUEREN CARBONELL;
Likewise, in the same birth record of Michelle, her father’s family name and mother’s maiden
family name were incorrectly registered as CARBONEL and PUERIN, respectively. They
should have been CARBONELL for her father’s family name and PUEREN for her mother’s
maiden family name;
32. That Michelle Puerin Carbonel per Certificate of Live Birth and Michelle Pueren
Carbonell, our neighbor, refer to one and the same person whose true and correct name is
MICHELLE PUEREN CARBONELL;
33. That we are not related with the family Carbonell either by affinity or by consanguinity and
that we have no interest of whatsoever with them;

RICHARD S. FLORIDA GRACE G. CABIGAS

Affiant Affiant
_________________________________________
Doc. No. _________;

Page No._________;
Book No. _________;
Series of 2015.

x---------------------------/
I, PENDATUN SOMOCO ALAUYA, of legal age, Filipino, married and a resident

of Davao City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and say:
7. That I am the driver of a SUBARU FORESTER WAGON bearing Plate No.

AAG 8579 owned by DOLE Philippines, Inc., STANFILCO Division, Doña
Socorro St., Belisario Heights, Lanang, Davao City;
8. That on or about October 22, 2015, at around 3:30 in the afternoon, while
at the farm of Dole in Bukidnon, the windshield of my driven vehicle was
hit by a flying stone;
9. That as a result thereof, the right portion of the windshield shattered to

pieces;
10.That I am executing this affidavit to attest the truth of the foregoing facts
and to submit the same to the authorities concerned for whatever purpose
this may serve.

PENDATUN S. ALAUYA
Affiant

foregoing.
________________________________________
Doc. No._________
Page No. ________
Book No._________
Series of 2015.

x--------------------------/
Affidavit
I, MARRY LOU CASERES SAN LUIS, 32 years of age, Filipino, single and with
address at Sitio Escuela, Catalunan Grande, Davao del Sur, Philippines, after having
1. That sometime in the year 2006, my mother-in-law was admitted at

the Southern Philippines Medical Center, Davao City, and needed
medicines;
2. That being a citizen of Davao City, I tried to avail the medical

assistance thru the LINGAP, however, to avail such privilege, one
must be a voter of the barangay where you reside;
3. That as such, I tried to register as a voter of Barangay Catalunan

Grande. However, one of the requirement is a valid identification
card which my elder sister possess;
4. That I requested my elder sister, SHERRY LOU CASERES SAN LUIS, to

allow me to use her ID and name to register as a voter which she was
forced to concede;

foregoing averments and to submit the Commission on Election
(COMELEC), Davao City, for whatever purpose this may serve.
IN WITNESS hereof, we have hereunto affixed our signatures this 26 th day of

MARRY LOU C. SAN LUIS

Affiant
SUBSCRIBED AND SWORN to before me this 26 th day of October, 2015, in the

and that I am satisfied that she voluntarily executed and understood the foregoing.
________________________________________
Doc.No.___________
Page No.__________
Book No.__________
Series of 2015.

x------------------------/
Affidavit Of Confirmation
We, PRIMA PATOLTOL CARPENTERO and GUALBERTA PATOLTOL

CAHILOG, both of legal age, Filipino, married and residents of New Dimiao, Biao
Guianga, Tugbok, Davao City, Philippines, under oath, depose and say:
1. That we are the same Prima Postrano Patoltol and Gualberta

Postrano Patoltol who are among the six (6) siblings of the late
VICTORIANO POSTRANO PATOLTOL, SR.;
2. That we have executed a Joint Affidavit consisting of two (2) pages;
3. That the said JOINT AFFIDAVIT which we have executed was not forged
nor fabricated;
4. That we hereby confirm that we are the same persons named as affiants
in the Joint Affidavit;
whatever purpose this affidavit may serve.

PRIMA P. CARPENTERO GUALBERTA P. CAHILOG

Affiant Affiant
__________________________, in the City of Davao, Philippines, and I HEREBY
CERTIFY that I have examined the affiants and that I am satisfied that they have
voluntarily executed and understood the foregoing.
________________________________
Doc. No. ____________;

Page No. ____________;
Book No.____________;
Series of 2015.

x------------------------/
Joint Affidavit
We, PRIMA PATOLTOL CARPENTERO and GUALBERTA PATOLTOL

CAHILOG, both of legal age, Filipino, married and residents of New Dimiao,
Biao Guianga, Tugbok, Davao City, Philippines, under oath, depose and say:
6. That we are the same Prima Postrano Patoltol and Gualberta

Postrano Patoltol who are among the six (6) siblings of the late
VICTORIANO POSTRANO PATOLTOL, SR. (Victoriano for
short), photocopy of the Certificates of Live Birth of the siblings are
hereto attached as Annex “A” and “A-1” are hereto attached to form
integral parts of this affidavit;
7. That Victoriano, Sr. died on March 8, 2005 at the Davao Medical

Center, Davao City, photocopy of his Certificate of Death is hereto
attached as Annex “B” is hereto attached to form integral part
hereof;
8. That he was born on December 2, 1940 in Kibalos, Barrio of

Balingasag, Misamis Oriental. Photocopies of Certificates No
Record issued by the National Statistics Office (NSO) dated
October 21, 2015 and of the Local Civil Registrar of Balingasag,
Misamis Oriental dated July 20, 1956 marked as Annexes “C” and
“C-1” are hereto attached to form integral parts hereof;
9. That he was married to PANCRACIA INDINO NEMENZO. Their

marriage was solemnized on September 11, 1966 at the St.
Ignatius Church, Monkayo, Davao. An NSO Authenticated Marriage
Contract marked as Annex “D” is hereto attached to form part
hereof;
10. That out of their marriage they begot seven (7) children, namely:
Name of Child Date of Birth Place of Birth
MARIE JOY November 5, 1967 Monkayo, Davao

VICTORIANO, JR. January 12, 1970 Davao City
MARIE GRACE April 5, 1972 Monkayo, Davao
MARIE BLESS January 19, 1974 Monkayo, Davao
JOSEPH February 3, 1976 Monkayo, Davao
BERNICE June 16, 1977 Monkayo, Davao
CHRISTIAN July 3, 1980 Quezon, Bukidnon
All surnamed NEMENZO PATOLTOL;
11. That we are executing this affidavit to attest to the truth of the
concerned for whatever purpose this affidavit may serve.
~ more ~
~ page 2 ~

PRIMA P. CARPENTERO GUALBERTA P. CAHILOG

Affiant Affiant

__________________________, in the City of Davao, Philippines, and I
HEREBY CERTIFY that I have examined the affiants and that I am satisfied that
they have voluntarily executed and understood the foregoing.
________________________________
x-------------------------/
Affidavit
I, ERLINDA L. BUTAL, of legal age, Filipino, married and a resident of

Riverside, Calinan, Davao City, Philippines, after having been duly sworn to in
k) That I am among the twelve (12) heirs of Rita Loengo Loperez for the
14,722-square meter parcel of land situated in the Barrio of Guianga,
Davao City;
l) That the said property has no pending case at the DARAB or at any of
its adjudicators, the Department of Agrarian Relation (DAR), the
Courts or at the Office of the President;
m) That I am executing this affidavit to attest to the truth of the foregoing

averments purposely to submit the same to the authorities concerned
for whatever purpose this may serve.

ERLINDA L. BUTAL
Affiant
SUBSCRIBED AND SWORN to before me this _________________________,

in the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the
affiant and that I am satisfied that she voluntarily executed and understood the
foregoing.
___________________________________
Doc. No.__________;
Page No._________;
Book No. _________;
Series of 2015.

x---------------------------/
Affidavit
I, WILFREDO MARY RODRIGUEZ JOVELLANO, 45 years of age, Filipino, married
and with address at Digos City, Davao del Sur, Philippines, after having been duly
n) That I am Police Officer 3 assigned in Provincial Highway Patrol

Team (PHPT), Digos City, Davao del Sur.I first came to the service
sometime in November 1,1995 and was first assigned at the
Regional Mobile Force Company, Isulan Sultan Kudarat. Thereafter,
I was assigned to different areas/provinces all over the Philippines ;
o) That to the best of my knowledge and belief, no case/complaint has

been filed against me during my length of service at the Police
Force;
p) That further, I have not submitted any counter affidavit or any

controverting evidence because I was not informed or have not
received any memorandum or complaint against me;
q) That I am executing this affidavit to attest to the truth of the

foregoing averments and to submit the same to the Investigation
Management Division, Headquarters Highway Patrol Group, with
prayer that my name be cleared in the DIDM Database.

PO3 WILFREDO R. JOVELLANO
Affiant

and that I am satisfied that he voluntarily executed and understood the foregoing.
________________________________________
Doc.No.___________
Page No.__________
Book No.__________
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, JOSE BALURAN and MANNY MARIANO, both of legal age, Filipino, married and
residents of Bugac Ma-a, Davao City, Philippines, respectively, after having been sworn to in
35. That we personally know the person of LEONORA CUISON

TORREON;
36. That she died on June 17, 2011 at the Southern Philippines Medical Center (SPMC),
Davao City;
37. That deceased’s death was registered at the Office of the Civil Registrar of Davao City.
However, her given name and middle name were erroneously registered as NORA and
CUIZON, respectively. It should have been LEONORA for the given name and
CUISON for the middle name;
38. That Nora Cuizon Torreon per Certificate of Death Certificate and Leonora Cuison
Torreon, our neighbor, refer to one and the same person whose true and correct name is
LEONORA CUISON TORREON;
39. That we are not related with the deceased either by affinity or by consanguinity and that
we have no interest of whatsoever with them;

JOSE BALURAN MANNY MARIANO

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x---------------------------/
Affidavit Of Personal Circumstances
I, WILFREDO RODRIGUEZ JOVELLANO, 45 years of age, Filipino, married and

with address at Digos City, Davao del Sur, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and say:
r) That I am Police Officer 3 assigned in Provincial Highway Patrol

Team (PHPT), Digos City, Davao del Sur.I first came to the service
sometime in November 1,1995 and was first assigned at the
Regional Mobile Force Company, Isulan Sultan Kudarat. Thereafter,
I was assigned to different areas/provinces all over the Philippines ;
s) That to the best of my knowledge and belief, no case/complaint has

been filed against me during my length of service at the Police
Force;
t) That further, I have not submitted any counter affidavit or any

controverting evidence because I was not informed or have not
received any memorandum or complaint against me;
u) That I am executing this affidavit to attest to the truth of the

foregoing averments and to submit the same to the Investigation
Management Division, Headquarters Highway Patrol Group, with
prayer that my name be cleared in the DIDM Database.

PO3 WILFREDO R. JOVELLANO

Affiant

and that I am satisfied that he voluntarily executed and understood the foregoing.
________________________________________
Doc.No.___________
Page No.__________
Book No.__________
Series of 2015.

x---------------------------/
Affidavit Of Circumstantial
Evidence
We, IRIS FE SUMA BELCIÑA and ERWIN BENEDICT SUMA BELCIÑA, both of
legal age, Filipino, married/single and residents of No. 36 Saguitarius, GSIS
Heights,Matina, Davao City, Philippines, after having been duly sworn to in
v) That we are among the Five (5) children of ELDIFONSO SAMSON

BELCIÑA;
w) That unfortunately, while I was at my senior year at the

Immaculate Concepcion College (ICC), my father left us to unknown
destination;
x) That as such, we grew up under our mother’s support;
y) That to date, we could not ascertain his whereabouts;
z) That we are executing this affidavit to attest the truth of the

Government Service Insurance System (GSIS) for whatever purpose
this may serve to our intent to request burial expenses refund of
our mother’s burial.

IRIS FE S. BELCIÑA ERWIN BENEDICT S. BELCIÑA

Affiant Affiant

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiants
and that I am satisfied that they voluntarily executed and understood the foregoing.
________________________________________
Doc.No.___________
Page No.__________
Book No.__________
Series of 2015.

x---------------------------/
Affidavit Of Loss
I, DR. MARK ANTHONY A. TOM, of legal age, Filipino, single and a resident of
Garden Heights Condominium, E. Rodriguez Sr., Quezon City, Philippines, after
aa) That I am a depositor of Security Bank;
bb) That as such, I was issued ATM Card;
cc) That unfortunately, on or about October 10, 2015, at

around 11:00 in the evening, my said ATM card was captured
at a Union Bank ATM booth at St. Luke’s Hospital, Quezon
City;
dd) That my said ATM was not alienated nor sold to any third
party;
ee) That I am executing this affidavit to attest the truth of the



Affiant

foregoing.
________________________________________

x---------------------------/
I, DR. JANET C. YAMYAMIN, of legal age, Filipino, single and a resident of

New Matina Riverside, Davao City, Philippines, after having been duly sworn to in
ff) That I am an owner of a duly registered motor vehicle,

described as:
Make/Series/Body Type HONDA SEDAN
Engine Number padgm2650dv414541
Chassis Number 115a75400511
Plate Number LHF-487
gg) That at around 4:00 o’clock in the afternoon of September

15, 2015, while maneuvering my said car at our garage, the
right portion of the front bumper as well as the right side of
the front fender up to the side (lower portion) of the right
door accidentally hit the metal railings of the gate;
hh) That as a result thereof, the said right portion of the front
bumper, the right side of the front fender and the side (lower
portion) of the right door were damaged;
ii) That I am executing this affidavit to attest the truth of the

foregoing averments for insurance purposes.

DR. JANET C. YAYAMIN

Affiant

foregoing.
________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and RICKY FLORIDA, both of legal age, Filipino, married
and residents of Mahogany St., Green Meadows Subd. and Brgy. 23-C, Mini-Forest, Quezon
Boulevard, Davao City, Philippines, respectively, after having been sworn to in accordance with
41. That we personally know the person of EVELYN FLORES
GALLIARDE;
42. That she is an unwed mother of three (3) children and the youngest is JAYLYE
FLORES GALLIARDE who was born on October 6, 2000 in Davao City;
43. That we know for a fact that Evelyn Flores Galliarde is a member of the Social Security
System (SSS). However, her record with the said office (SSS) shows that her youngest child’s
(JAYLYE) middle and family names were erroneously registered as GARIALDE and
ARAYAN,respectively. It should have been FLORES for her middle name and
GALLIARDE for the family name to conform with the maiden middle and family name
of the CHILD’S MOTHER Evelyn Flores Galliarde;
44. That Jaylye Garialde Arayan per Certificate of Live Birth and Jaylye Flores Galliarde,
our neighbor’s child, refer to one and the same person, referring to the youngest child of
Evelyn Flores Galliarde whose true and correct name is JAYLYE FLORES
GALLIARDE ;
45. That we are not related with the Galliardes either by affinity or by consanguinity and that

AMERICUS S. YANONG RICARDO S. FLORIDA

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and RICKY FLORIDA, both of legal age, Filipino, married
and residents of Mahogany St., Green Meadows Subd. and Brgy. 23-C, Mini-Forest, Quezon
Boulevard, Davao City, Philippines, respectively, after having been sworn to in accordance with
47. That we personally know the person of EVELYN FLORES

GALLIARDE;
48. That she is an unwed mother of three (3) children and the second is : ANALEEZA
FLORES GALLIARDE who was born on November 3,1999 in Davao City;
49. That we know for a fact that Evelyn Flores Galliarde is a member of the Social Security
System (SSS). However, her record with the said office (SSS) shows that her child’s
(Analeeza’s) family name was erroneously registered as GARIALDE. It should have
been GALLIARDE to conform with the true and correct family name of her mother;
50. That Analeeza Flores Garialde per Certificate of Live Birth and Analeeza Flores
Galliarde, our neighbor’s child, refer to one and the same person whose true and correct
family name is GALLIARDE;
51. That we are not related with the Galliardes either by affinity or by consanguinity and that

AMERICUS S. YANONG RICARDO S. FLORIDA

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x-------------------/

above;
one of the borders;
ALLAN L. MACASINDIL
Affiant
________________________________________
Doc. No. _________;

Page No. _________;
Book NO. _________;
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and FLORENCIO BALURAN, both of legal age, Filipino,
married and residents of Mahogany St., Green Meadows Subd., and Nograles Avenue,
Bucana, Davao City, Philippines, respectively, after having been sworn to in accordance with
53. That we personally know the person of JUMDA IBRAHIM

MOHAMMAD;
;
54. That she is the child of spouses ALI MOHAMMAD and NANNUARA IBRAHIM who was
born on August 12, 1958 in Davao City;
55. That wek now for a fact that she has not contracted marriage to any man here or anywhere
in the Philippines;
56. That her COMELEC ID however shows that her civil status is MARRIED. It should
have been SINGLE because Jumba Ibrahim Mohammad is still single up to this writing;
57. That we are not related either by affinity or by consanguinity and that we have no interest
of whatsoever with her;

AMERICUS S. YANONG FLORENCIO BALURAN

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.
59. That we personally know the person of ARCELI CAGAMPANG
SEROJE; ;
60. That she is the child of spouses TRANQUILINO PADILLA SEROJE and CORAZON
ALABA CAGAMPANG who was born on April 2, 1981 in Gingoog City;
61. That her birth was registered at the Local Civil Registrar of Gingoog City, however, her
father’s name was erroneously registered as TRANGQUILINO. It should have been
TRANQUILINO to conform with the true and correct name of her father;
Furthermore, the middle name of his father was not reflected. It should have reflect the middle
name PADILLA..
62. That TRANGQUILINO SEROJE, father’s name of Arceli Cagampang Seroje

per Certificate of Live Birth and TRANQUILINO PADILLA SEROJE, our
neighbor, refer to one and the same person, referring to the father of Arceli Cagampang
Seroje; the same could be gleaned in the Certificate of Live Birth of her sister, YLIETA EDNA
CAGAMPANG SEROJE;
of whatsoever with the deceased; and

ARMANDO C. CANOY VIRGILIO SR. M. CADENAS

Affiant Affiant
SUBSCRIBED AND SWORN to before me this ________________________ in the City of

Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiants and that I am satisfied that
they executed voluntarily and understood the foregoing affidavit.
_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x--------------------------/
Affidavit
I, CIENCIA YANONG PLAZA, of legal age, Filipino, married and a

resident of No. 34 Watusi St., Buhangin, Davao City, Philippines, after having
jj) That I am the legal guardian of my fifteen (15) – year old grandson,
DRAZEN PLAZA GAMAS
kk) That he is scheduled to undergo an interview for Commission on

Filipino Overseas (CFO) and Pre-Departure Orientation Seminar
(PDOS) in Cebu;
ll) That to attend said seminar, my grandson needs to be accompanied

by the undersigned as legal guardian;
mm) That however I am sickly and it is hard for me to travel to Cebu.

As such, I hereby delegate my granddaughter, Drazen’s elder sister,
RASHA ANNE PLAZA GAMAS, to accompany my grandson to attend
the seminar.;
nn) That I am executing this affidavit to attest to the truth of the


CIENCIA Y. PLAZA
Affiant
SUBSCRIBED AND SWORN to before me this 7 TH day of October, 2015, in

________________________________________
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ARMANDO C. CANOY and VIRGILIO SR. M. CADENAS, both of legal age,
Filipino, married and residents of Gingoog City, after having been sworn to in accordance with
65. That we personally know the person of ARCELI CAGAMPANG

SEROJE; ;
66. That she is the child of spouses TRANQUILINO PADILLA SEROJE and CORAZON
ALABA CAGAMPANG who was born on April 2, 1981 in Gingoog City;
67. That her birth was registered at the Local Civil Registrar of Gingoog City, however, her
TRANQUILINO to conform with the true and correct name of her father;
name PADILLA..
68. That TRANGQUILINO SEROJE, father’s name of Arceli Cagampang Seroje

neighbor, refer to one and the same person, referring to the father of Arceli Cagampang
Seroje; the same could be gleaned in the Certificate of Live Birth of her sister, YLIETA EDNA
CAGAMPANG SEROJE;


Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ARMANDO C. CANOY and VIRGILIO SR. M. CADENAS, both of legal age,
Filipino, married and residents of Gingoogt City, after having been sworn to in accordance with
71. That we personally know the person of VENJOR CAGAMPANG

SEROJE; ;
72. That he is the child of spouses TRANQUILINO PADILLA SEROJE and CORAZON
ALABA CAGAMPANG who was born on February 27,1985 in Balingasag, Misamis Oriental;
73. That his birth was registered at the Local Civil Registrar of Misamis Oriental, however, his
TRANQUILINO to conform with his true and correct name;
name PADILLA..
74. That TRANGQUILINO SEROJE, father’s name of Venjor Cagampang Seroje

neighbor, refer to one and the same person, referring to the father of Venjor Cagampang
Seroje; the same could be gleaned in the Certificates of his sisters, ARCELI CAGAMPANG
SEROJE and YLIETA EDNA CAGAMPANG SEROJE;


Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.
x--------------------------/
Affidavit/Waiver
We, the undersigned HEIRS OF TERESITA ABIAR VDA. DE OMALZA, all of

legal age, Filipino and residents of Toril, Davao City, Philippines, after having
oo) That we are the legitimate heirs of TERESITA ABIAR VDA.

DE OMALZA who died on December 17, 2013 in Toril, Davao
City;
pp) That during her lifetime, the deceased was a member of

theTagabawa, Ubo, Klata Bisaya Integrated Settler’s
Association (TUKBISA),
qq) That being a member, she was allotted a ONE HUNDRED

FIFTY (150) SQUARE METER lot at Tukbisa, Marapangi, Toril,
Davao City;
rr) That we hereby waive our rights and interest over the said
property unto and in favor of our sibling ELEONOR ABEAR
OMALZA-KOSAKA;
ss) That we likewise authorize our said sibling to negotiate

with the TUKBISA purposely to claim and possess the said
lot;;
tt) That we are executing this affidavit with our own free act and
volition attesting the truth of the foregoing averments.

Conforme:
ELEONOR O.KOSAKA JOEL A. OMALZA

Affiant Affiant
MARILYN O. DUNQUE AMALIA A. OMALZA

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 1 st day of October, 2015, in

________________________________________
Doc.No.__________
Page No. _________
Book No. _________
Series of 2015.
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, JEHAN NAKILAN and RICKY FLORIDA, both of legal age, Filipino, married and
residents of Brgy. 23,-C, Mini-Forest, Quezon Boulevard, Davao City, Philippines, respectively,
after having been sworn to in accordance with law do hereby depose and state that:
77. That we personally know the person of NORMA GUINDOLAN TAMBA

who is the lawfully wedded wife of Eduardo Tamba Sr.;
78. That she is now confined at the Southern Philippines Medical Center (SPMC), and is
intending to avail LINGAP medical assistance, however, in her Voter’s Affidavit which is one of
the requisite documents, her family name registered is NORMA GEINDULAN
ARROGANTE. It should have been NORMA GUINDOLAN TAMBA to
conform with her true and correct name having been legally married to Eduardo Tamba,
Sr.;
79. That NORMA GEINDULAN ARROGANTE per Voter’s Affidavit and NORMA
GUINDOLAN TAMBA, our neighbor, referring to the wife of Eduardo Tamba, Sr., is one and
the same person whose true name is NORMA GUINDOLAN TAMBA;

JEHAN NAKILAN RICKY FLORIDA

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x------------------------/
I, JUNNA MAE SARIMA SARITA, of legal age, Filipino, single and a

resident of km. 23, Purok 10, Bosque, Bunawan, Davao City, Philippines, after
82. That I am the Attorney-In-Fact of AUBREY MAE D.CHAVEZ. Photocopy

of a Special Power of Attorney dated February 26, 2015 notarized by Atty. Efren
E. Cachuela docketed as Doc. No. 468; Page No. 92; Book No. 24 and Series
of 2015 is hereto attached to form part of this affidavit;
83. That my principal, Ms. AUBREY MAE D.CHAVEZ has purchased a 400
square meter from the 2,123 square meter-parcel of land of the property
of Erlinda A. Vega described in TCT-382776 of the Registry of Deeds for
Davao City, situated in the Barangay of Cabantian, Davao City;
84. That the metes and bounds of the 400-square meter sold to my principal
were determined in a survey and the particulars of which are as follows:
Lot 86-B-5-B-2, Psd-11-117203
A parcel of land ( Lot 86-B-5-B-2, Psd-11-117203 being a portion of 86-B-5-B,

Psd-11-096063), situated in the Barangay of Cabantian; City of Davao; Island
of Mindanao. Bounded as follows: On the NE.,& S., along lines 3-4-1 by lot 86-
B-5-B3; on the SW., along line 1-2 by lot 86-B-5-B-1, both of the subd. Plan; on
the NW., a long line 2-3 by lot 86-B-7(RROW) Psd-11-090735. Beginning at a
point marked “1” on plan being N. 36 deg. 38’E., 3170.17 m. from BLLM No.
17, CAD. 102;
THENCE……………………..
N, 63 deg. 47’ W., 14.77 m. to point 2;

N. 31 deg. 30’ E., 30.25 m. to point 3;
S. 41 deg. 30’ E., 15.22 m. to point 4;
S. 30 deg. 49’ W., 24.44 m. to point of beginning; and
Containing an area of FOUR HUNDRED (400) SQUARE METERS, more or
less. Points referred to are indicated on the plan and are marked on the ground
as follows: corner 2 by Old PS & rest by PS cyl. Conc. Mons. 15x50 cms.
Bearings, true. Date of Original survey, March 10, 1955 and that of the
subdivision survey July 28, 2011 executed by Geodetic Engineer Samuel C.
Serrano and approved on December 02, 2011
~ more ~
~ page 2 ~
85. That the purchase of the said 400-square meter lot is evidenced by an
instrument, DEED OF ABSOLUTE SALE dated January 27, 2015 notarized
by Atty. Efren E. Cachuela docketed as Doc. No. 222; Page No. 45; Book No.
21 and Series of 2015 which is hereto attached to form part hereof;
86. That however, in the said document, the sale of the 400-square meter was
indicated as part of the 2,123-square meter parcel of land as described in TCT
No. 382776. It should have been TCT No. 412906 because the
former TCT number was cancelled upon registration of another portion of the
land sold by the owner Erlinda A.Vega;
averments, purposely to apprise the authorities concerned of the 400-square
meter parcel of land purchased by my principal Aubrey Mae D, Chavez from
Erlinda A. Vega.

JUNNA MAE S.SARITA

Affiant
SUBSCRIBED AND SWORN to before me this ________________________ in the

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am
satisfied that she executed voluntarily and understood the foregoing affidavit.
_________________________________________
Doc.No. ____________;
Page.No. ___________;
Book.No. ___________;
Series of 2015
x------------------------/
Affidavit For Change

Of Civil Status
I, JUPITER, JR. DUROPAN SANCHEZ, of legal age, Filipino, single and

a resident of 561 Carnation St., Buhangin, Davao City, Philippines, after having
been sworn to in accordance with law do hereby depose and state:
88. That I have contracted marriage with LEA ZOPHIA PEÑA KUIZON. Our
marriage was solemnized on September 8, 1995 at the Our Mother of Perpetual
Help, Bajada, Davao City;
89. That as such my civil status in my personal records at any office is

MARRIED;
90. That lately, I have filed a petition for Nullity of Marriage Vows and the same
was granted by the Regional Trial Court, Branch 20, Digos City, Davao del Sur.
As such, my civil status now is SINGLE;
averments purposely to submit the same to the authorities concerned to request
for the change of my civil status from MARRIED to SINGLE.

JUPITER D. SANCHEZ, JR.

Affiant

satisfied that he executed voluntarily and understood the foregoing affidavit.
_________________________________________
Doc.No. ____________;
Page.No. ___________;
Book.No. ___________;
Series of 2015
x------------------------/
Affidavit For Change

Of Civil Status
I, JUPITER, JR. DUROPAN SANCHEZ, of legal age, Filipino, single and

a resident of 561 Carnation St., Buhangin, Davao City, Philippines, after having
92. That I am a holder of Professional Driver License No. LO2-01-150694

issued by the Land Transportation Office, Davao City Agency;
93. That my personal records at the Land Transportation Office shows that my
civil status is MARRIED;
94. That lately, my petition for Nullity of Marriage Vows was granted by the
Regional Trial Court, Branch 20, Digos City, Davao del Sur. As such, my civil
status now is SINGLE;
averments purposely to submit the same to the Land Transportation Office of
Davao City to request for the change of my civil status from MARRIED to
SINGLE.

JUPITER D. SANCHEZ, JR.

Affiant

satisfied that he executed voluntarily and understood the foregoing affidavit.
_________________________________________
Doc.No. ____________;
Page.No. ___________;
Book.No. ___________;
Series of 2015

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, LYDIA VILLABAN and REYNALDO PISANON, both of legal age, Filipino,
married and residents of Almasiga St., Inahan sa Kanunay’ng Panabang (IKP), Brgy. Lapu-
lapu, Agdao, Davao City, Philippines, respectively, after having been sworn to in accordance
with law do hereby depose and state that:
96. That we personally know the person of PRESCILLA DINGLASA CAÑETE who
died on March 30, 2014 at their house in Prk.8, IKP, ,Brgy. .Lapu-lapu, Agdao, Davao City;
97. That in the Certificate of Death, the given name of the deceased was erroneously spelled
as PRESCILA. It should have been PRESCILLA to conform with the correct spelling of the
deceased’s name as it appearsin all other documents pertaining to the Dinglasa-Cañete family;
FURTHERMORE, in the same Certificate of Death, the maiden family name of the
deceased’s mother, TERESITA BABOR, was incorrectly registered as MIMIS. It should have
been BABOR to conform with the mother’s maiden family name of her children as it appears in
the respective certificate of live births of the children;
98. That PRESCILA.DINGLASA CAÑETE per Certificate of Death and PRESCILLA

DINGLASA CAÑETE, our neighbor, refer to one and the same person whose true and correct
name is PRESCILLA DINGLASA CAÑETE;
FURTHERMORE, TERESITA MIMIS, registered as mother of the deceased in the same

Death Certificate and TERESITA BABOR, our neighbor’s mother, refer to one and the same
person whose true name is TERESITA BABOR;
99. That we are not related either by affinity or by consanguinity and that we have no nterest of
whatsoever with the deceased; and
LYDIA VILLABAN REYNALDO PISANON

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x------------------------/
JOINT AFFIDAVIT
We, ADANILO LOCABO LANOY and BOBBY BORROMEO, both of legal age,
Filipino, married and residents of Mountain View Village, ,Cabantian and Bucana, Davao City,
and state:
101. That we personally know the person of HILMARK AYUBAN who is an

illegitimate child of MARIA FE AMOGUIS AYUBAN and HILARIO
MALABO MISTAL who was born on May 22, 1996 in Misamis Oriental;
102. That his birth was registered, however being an illegitimate, his family
name registered is that of his mother’s family name AYUBAN;
103. That however, later sometime in 2004, under Republic Act 9255, his
father’s family name was registered as the family name of Hilmark.
Photocopy of his SSS record, Pag-ibig, school record and other personal
records are hereto attached showing that Hilmark has now been using
MISTAL for his family name;
104. That HILMARK AYUBAN per NSO authenticated Certificate of Live Birth and
HILMARK AYUBAN MISTAL whose name appears to be registered at
the SSS, Pag-ibig, school records and other personal records of our
neighbor, refers to one and the same person, referring to HILMARK
AYUBAN MISTAL;
interest of whatsoever with the deceased; and

ADANILO L. LANOY BOBBY BORROMEO,

Affiant Affiant

_________________________________________
Doc.No.__________;
Page No._________
Book No. _________
Series of 2015.

x------------------------/
AFFIDAVIT
I, ROMEOARMEDILLA, of legal age, Filipino, married and a resident of Brgy. 5-

A,Bankerohan,, Davao City, Philippines, after having been sworn to in accordance with law do
hereby depose and state:
107. That I personally know the person of MARY JEAN OQUINA PATAYON
who is a resident of Maharlika Village, Matina Aplaya, Davao City;
108. That she was married to REIO AOKI, a Japanese national. Their
marriage was solemnized on September 14,2001 at the PUC, 193
Bayanihan St., Baesa, Caloocan, Metro Manila;
109. That for the said solemnization of their marriage, I along with Mary Jean and her
family had to go to Baesa, Caloocan City;
110. That out of wedlock, they were blessed with three (3) children:
Name Date of Birth Place of Birth
REIKA PATAYON AOKI December 3, 2004 Japan

REIJI PATAYON AOKI December 3, 2004 Japan
AIKA PATAYON AOKI March 8, 2002 Japan
111. That their marital union however did not last long. While in Japan, Reio
Aoki left Mary Jean and their children under utter deprivation of support
and love. Thereafter, Mary Jean brought their children here in Davao City
for financial reason and traveled back to Japan to earn a leaving;
112. That I have personal knowledge of the facts above because, aside
from being good friends, I am her godparent;
113. That I am executing this affidavit to attest the truth of the foregoing averments.

ROMEO ARMEDILLA
Affiant

Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that
he executed voluntarily and understood the foregoing affidavit.
_________________________________________
Doc.No. ____________;
Page.No. ___________;
Book.No. ___________;
Series of 2015

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
Affidavit
Of No Improvement
I, AREZA LOPEREZBUTAL. of legal age, Filipino, single and a

resident of Purok 6, Riverside, Calinan, Davao City; Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
say that:
1. That I am the new owner of a 14,722 square meter parcel of

land situated in Guianga, Davao City, the title thereto being
evidence by Transfer Certificate Of Title No.EP-1299 of the
Registry of Deeds for Davao City;
2. That the said parcel of land has no improvement of

whatsoever;
foregoing averments and to submit the same to the
IN WITNESS WHEREOF, I have hereunto set my hand this

________________________ at the City of Davao, Philippines.
AREZA L.BUTAL
Affiant

_______________________, in the City of Davao, Philippines and I further
certify that I have personally examined the affiant and I am satisfied that
she voluntarily executed and understood her affidavit.
Doc.No. ____________;
Page.No. ___________;
Book.No. ___________;
Series of 2015

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, A___________________________ and P____________________, both of legal

age, Filipino, married and residents of _________________________________and
__________________________, Davao City, Philippines, respectively, after having been sworn
to in accordance with law do hereby depose and state:
114. That we personally know the person of YOLIFE SANICO PEPUGAL who
is the wife of Jose Maphilindo Antonioo Abequibel and mother of Kurley
Pepugal Abequibel;
115. That she is a holder of Philippine Passport No. XX3101123.

However, her name appears to be registered as MA. YULYFE
ABEQUIBEL It should have been YOLIFE SANICO PEPUGAL to
conform with the records of her daughter Kurley Pepugal Abequibel; .
116. That MA. YULYFE ABEQUIBEL who is the registered holder of
Philippine Passport No. XX3101123 and YOLIFE SANICO
PEPUGAL who is the wife of Jose Maphilindo Antonioo Abequibel and
mother of Kurley Pepugal Abequibel, our neighbor, refer to one and the same
person whose true and correct name is YOLIFE SANICO PEPUGAL. ;

_______________________ ________________________
Affiant Affiant

_________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and PAULINO C. ROMARATE, both of legal age,

Filipino, married and residents of Mahogany St., Green Meadows Subd., and Nograles Avenue,
Bucana, Davao City, Philippines, respectively, after having been sworn to in accordance with
119. we personally know the person of RAYMUDO CAÑETE TECSON who

died on September 9, 2015 at Inahan Sa Kanunay’ng Panabang (ITP), Brgy. Lapu-
lapu, Almasiga St, Agdao, Davao CDity;
120. In the Certificate of Death however, his middle was incorrectly registered as
MEMIS. It should have been CAÑETE to conform with his true and correct5 middle
name;
121. RAYMUNDO MEMIS TECSON whose name appears to be registered in

the Certificate of Death and RAYMUNDO CAÑETE TECSON, our neighbor,
refer to one and the same person whose true and correct name is RAYMUNDO
CAÑETE TECSON. ;
FURTHERMORE, in the same Certificate of Death, his date of birth was likewise
incorrectly reflected as 16 MAY 1937. It should have been 15 MAY 1937;
122. we are not related either by affinity or by consanguinity and that we have no

AMERICUS S. YANONG PAULINO S. ROMARATE

Affiant Affiant

_________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and PAULINO C. ROMARATE, both of legal age,

Filipino, married and residents of Mahogany St., Green Meadows Subd., and Purok 5,Manuel
Guinga, Tugbok District, Davao City, Philippines, respectively, after having been sworn to in
124. we personally know the person of RUDOLFO MALIMA LUPIBA, SR. who
is the husband of JOSEPHINE TAGALOG LUPIBA ;
125. he is the eight (8th) child of the nine (9) children of spouses PEDRO E.
LUPIBA, SR. and SABINA MALIMA ;
126. his certificate of live birth however shows that his family name is registered as
LOPIBA . It should have been LUPIBA . Likewise, his father’s family name should
have also been registered as LUPIBA;
127. RUDOLFO LOPIBA whose name appears to be registered in the registry of

Live Births at the National Statistics Office (NSO) and RUDOLFO MALIMA
LUPIBA , SR. our neighbor, refer to one and the same person whose true and
correct name is RUDOLFO MALIMA LUPIBA, SR. ;
FURTHERMORE, in the same Certificate of Live Birth, the given name of Rudolfo’s
mother is erroneously registered as SAVINA. It should have been SABINA ;
IN WITNESS HEREOF, we have hereunto affixed our signatures this August 25,, 2015 in the
AMERICUS S. YANONG PAULINO C. ROMARATE,JUDITH C. MONAPCO

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 25th day of August 2015 in the City of Davao,
_________________________________________

x-------------------/
Affidavit Of Loss
I, PFC RAYNATO DEL ROSARIO BULARON, of legal age, Filipino and a

resident of Brgy. Salingcomot Baganga Davao Oriental , Philippines, after having
1. That I am a holder of PAFC I.D CARD issued byPAFC;
2. Diligent efforts exerted to locate my lost PAFC ID proved to no

avail, hence, the same is deemed lost beyond recovery; and

foregoing facts purposely to apprise the office concerned
purposely to request for a replacement of my said lost school
ID.

____________________________, in the City of Davao, Philippines.
PFC RAYNATO DEL ROSARIO BULARON

Affiant
SUBSCRIBED AND SWORN to before me this ____________________________, in the

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I
am satisfied that the affiant voluntarily executed and understood the foregoing.

x-------------------/
Affidavit
I, AMERICUS S. YANONG, 67 years of age, Filipino, defacto separated and

residing at residents of Lot 38, Block 35, Mahogany St., Green Meadows Subd., Tugbok
District, Davao City, Philippines, after having been sworn to in accordance with law do
4. That I am a member of the Social Security System (SSS);

5. That considering that I have separated from my wife and having
cohabited with another woman and having two (2) living
children with her, namely:
Maria Annie October 30, 1993 Davao City

Lovely Ann July 23, 2000 Davao City
I intend to amend my record with the SSS pertaining to my

beneficiaries and have my children mentioned above as my
beneficiaries;
6. That I am executing this affidavit with my own free act, to attest

to the truth of the foregoing facts purposely to request the
Social Security System to cause the registration of my
beneficiaries mentioned above.
IN WITNESS hereof, I have hereunto affixed my signature this 19 th of August,

AMERICUS S. YANONG
Affiant
SUBSCRIBED AND SWORN to before me this 19 th day of August, 2015, in the City of
satisfied that the affiant voluntarily executed and understood the foregoing.
________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and JULIE S. WAGA, both of legal age, Filipino, married
and residents of Mahogany St., Green Meadows Subd., Tugbok District, Davao City,
and state that:
130. we personally know the person of Carmelita Salas Geconcillo (Lola Carmelita
for short) who is the mother of our neighbor Rogelia Salas Geconcillo;
131. Lola Carmelita is eighty two (82) years old. As such, being a Senior Citizen, she
received MONTHLY PENSION for Senior Citizen from the Government through the
Municipal Government of Makilala, North Cotabato;
132. however, sometime in March 2014, she was not able to receive her PENSION
because her given name listed at the roster for Senior Citizen was changed to
ANALIZA. It should have been CARMELITA;
133. ANALIZA GECONCILLO whose name is now registered as Pensioner at the

roster of Senior Citizen of Old Bulatukan, Makilala, North Cotabato and CARMELITA
GECONCILLO, our neighbor’s mother, refer to one the same person whose true
and correct name is CARMELITA SALAS GECONCILLO;
IN WITNESS HEREOF, we have hereunto affixed our signatures this August 11, 2015 in the City
of Davao, Philippines.
AMERICUS S. YANONG JULIE S. WAGA

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 11th day of August 2015 in the City of Davao,
_________________________________________

x-------------------/
Affidavit Of Loss
I, JASON BENITEZ JALIN, 17 years of age, Filipino, college student of USEP

and a resident of Almasiga St., Green Meadows Subd., Brgy. Sto. Niño Tugbok
District. Davao City, Philippines, after having been sworn to in accordance with law
7. I am a bonafide student of the University of Southern Philippines

(USEP), Davao City;
8. As such I was issued a USEP identification card (ID);
9. Unfortunately, on or about January 30,2015, upon arrival at my

place of residence from school, I discovered the loss of my ID;
10. Diligent efforts exerted to locate my lost ID proved to no

avail, hence, the same is deemed lost beyond recovery; and
11. That I am executing this affidavit to attest to the truth of

the foregoing facts purposely to apprise the office concerned
purposely to request for a replacement of my said lost school
ID.

____________________________, in the City of Davao, Philippines.
JASON BENITEZ JALIN

Affiant

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and JOCELYN L. BATULA, both of legal age, Filipino,
married and residents of Madapo Hills, Bankerohan, Davao City, Philippines, respectively, after
136. That we personally know the person of Gualberto Patricio Geconcillo who died
on July 2, 2014 in Old Bulatukan, Makilala, North Cotabato;
137. That in his Death Certificate , his mother’s name is incorrectly registered as
LUISA PATRICIO. It should have been LORETA PATRICIO to conform with the true
and correct name of the mother of the decedent Gualberto Patricio Geconcillo as could
be gleaned in his Marriage Contract;
138. That Luisa Patricio per Death Certificate of Gualberto Patricio Geconcillo and
Loreta Patricio per Marriage Contract of Guaberto Patricio Geconcillo refer to one the
same person whose true and correct name is LORETA PATRICIO;

AMERICUS S. YANONG JOCELYN L. BATULA

Affiant Affiant
SUBSCRIBED AND SWORN to before me this _________________________ in the City of

_________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS SOTTO YANONG and RUBINA LAZAGA DAVIDE, both of legal age,
Filipino, married and residents of Green Meadows Subd., Brgy. Sto. Niño, Tugbok District, Davao City,
Philippines, respectively, after having been sworn to in accordance with law do hereby depose and state:
141. That we personally know the person of GLEN ASTUDILLO DAGONGDONG

who is our neighbor in our place of residence;
142. That he is the eighth (8 th) of the nine (9) children of spouses Rodrigo Bermoy
Dagongdong and Evangeline Mondan Astudillo;
143. That he is a member of the Social Security System (SSS), however, he has two (2)
SSS record:: SS Number 09-2453000-9 and SS NUMBER 09-3253436-9;
144. That in his two (2) SSS membership records, his middle name is incorrectly
registered as MONDAN. Mondan is the middle name of his mother;. It should have
been ASTUDILLO to conform with the family name of his mother;:
145. That GLEN MONDAN DAGONGDONG per SSS records and GLEN
ASTUDILLO DAGONDGONG, our neighbor, refer to one and the same person
whose true and complete name is GLEN ASTUDILLO DAGONGDONG;
interest of whatsoever with Glen Astudillo Dagongdong;and
IN WITNESS HEREOF, we have hereunto affixed our signatures this 22 nd day of September
2014 in the City of Davao, Philippines.
AMERICUS S. YANONG RUBINA L. DAVIDE

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 22 nd day of September 2014 in the City of
_________________________________________
x-------------------/
I, ROSITA A. ALCANTARA, of legal age, Filipino, married and a resident

of Lot 1, Blk. 1, Catalunan Pequeño, Davao City, Philippines, after having
1. That I am purchased a motor vehicle described as:
MAKE 3 DOOR MITSUBISHI PAJERO

MOTOR NO. 4M40AY2959
CHASSIS NO. V264019389
PLATE NO. MFB789
from ROGELIO MAGO GENON;
2. That the said motor vehicle is subject of a mortgage

agreement with DYNO Finance Company;
3. That all documents pertaining to the purchase and other

documents of the motor vehicle subject of the sale are now
with the undersigned;
4. That I hereby assume all the obligation with the mortgagee as

if I am the mortgagor entered into in a Mortgage Contract by
Mr. Rogelio M. Genon with DYNO;

foregoing averments purposely to submit the same to DYNO
Finance Company for whatever purpose this may serve.

ROSITA A. ALCANTARA
Affiant
SUBSCRIBED AND SWORN to before me this ______________________ at

Davao City, Philippines, and I HEREBY CERTIFY that I have examined the affiant and
that I am satisfied that she voluntarily executed and understood the foregoing affidavit
thereof.
_______________________________________

x-------------------/
Affidavit Of Loss
I, SAMUEL DAVE REALISTA, of legal age, Filipino, single and a resident of

Davao City, Philippines, after having been sworn to in accordance with law do
12. I am a bonafide employed as Team Development Leader

of VXI Global Holdings with office address JP Laurel Ave.,
Robinsons Cybergate, Bajada, Davao City;
13. As such I was issued a Company Identification Card

(Company ID);
14. Unfortunately, my said Company ID was lost in my

possession and despite diligent efforts exerted to locate, the
same could not be found; and

the foregoing facts purposely to apprise VXI Global Holdings of
the foregoing averments and to request for a replacement of my
said lost Company ID.
IN WITNESS hereof, I have hereunto affixed my signature this 27 th of

January, 2014, in the City of Davao, Philippines.
SAMUEL DAVE REALISTA

Affiant
SUBSCRIBED AND SWORN to before me this 27 th day of January, 2014, in the City of
________________________________________
x-------------------/
Affidavit Of Loss
I, HANNA MARIE A. PEDARIOS, 14 years old, Filipino, second year student

of Holy Child College of Davao City and a resident of Almasiga St., Green Meadows
Subd., Brgy. Sto. Niño, Tugbok District, Davao City, Philippines, after having been
sworn to in accordance with law do hereby depose and state that:
16. I am a holder of an Automatic Teller Machine card (ATM)

issued by Banco de Oro, SM Branch, Davao City;
17. The said ATM was misplaced in my place of residence and

despite diligent efforts exerted to locate, the same could not be
found;
18. The lost ATM was not a subject of a loan/borrowing or in

any manner alienated to third party/person;

the foregoing facts purposely to apprise Banco de Oro of the
foregoing averments and to request for a replacement.
IN WITNESS hereof, I have hereunto affixed my signature this 21 st of

Assisted by:
LYN D. ABALOS HANNA MARIE A. PEDARIOS

Parent Affiant
SUBSCRIBED AND SWORN to before me this 21 st day of January, 2014, in the City of
satisfied that the affiant, assisted by her parent, voluntarily executed and understood the
foregoing.
________________________________________
x------------------------/
I, TITO VESA TAGRA, of legal age, Filipino, married and a resident of km. 9 Catalunan Pequeño,
Davao City, Philippines, under oath, depose and say:
1. That I am the father of IRISH MAE SALARZA TAGRA who is now 18 years of age;
2. That she is still single and unemployed. As such, she is my dependent being under my
financial support;
3. That she has delivered her child (female) yesterday September 4, 2013 at the
Southern Philippines Medical Center, Bajada, Davao City;
4. That I am executing this affidavit to attest to the truth of the foregoing averments and
to submit the same to the authorities concerned for whatever purpose this affidavit
may serve to my intent to avail Philhealth benefits for my dependent.
IN WITNESS hereof, we have hereunto affixed our signatures this 6 th day of September, 2013, in
TITO V. TAGRA
Affiant
SUBSCRIBED AND SWORN TO before me this 4 th day of September,2013, in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that the affiant
_______________________________________
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and ARTURO FAELDEN, both of legal age, Filipino, married
and residents of Green Meadows Subd., Brgy. Sto. Niño, Tugbok District, Davao City, Philippines,
148. That we personally know the person of WENEFREDO ORAN PADULLON who
is our neighbor in our place of residence;
149. That he is the third child of the five(5) children of spouses Temotio Padullon and
Arsenia Oran who was born on November 3, 1950;
150. That his Certificate of Live Birth however shows that he was registered as:
Name Date of Birth
WINCESLAO ORAN PADOLEON November 3, 1950
While in his other personal record, including that of his record with the Social Security
System (SSS), it shows his registered:
Name Date of Birth
WENEFREDO ORAN PADULLON November 3, 1954
151. That WINCESLAO ORAN PADOLEON whose date of birth is November 3,

1950 per Birth Certificate and WENEFREDO ORAN PADULLON whose date of
birth is November 3, 1954 per SSS record and all other personal documents, refer
to one and the same person known to us as WENEFREDO ORAN PADULLON;
interest of whatsoever with Wenefredo Oran Padullon or Winceslao Oran Padoleon;
and
153. That we are executing this affidavit to attest the truth of the foregoing averments
and to submit the same to the authorities concerned for whatever purpose this affidavit
may serve.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 22 nd day of August, 2013 in
AMERICUS S. YANONG ARTURO FAELDEN

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 22nd day of August, 2013 in the City of Davao,
voluntarily executed and understood the foregoing affidavit.
_________________________________________

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, SHERWIN G. MURILLO and ISIDRO O. MISSION, both of legal age, Filipino,
married and residents of Blk. 6, Lot 18 San Lorenzo, Puan and Candelaria St., Ecoland,
Matina, Davao City, Philippines, respectively, after having been sworn to in accordance with law
154. We personally know the person of FREDIE LOU MANCERA AYA-

AY;
155. He is the second of the two (2) children of spouses Florencio Aya-ay and
Lucrecia Mancera;
156. On June 24, 2013, at thirty four (34), Fredie Lou died of bacterial
infection at the Southern Philippines Medical Center, Bajada, Davao City;
157. In his Death Certificate however, his CIVIL STATUS was incorrectly
reflected as MARRIED. It should have been SINGLE to conform with his true
and correct civil status;
158. We hereby declare under oath that Fredie Lou Mancera Aya-ay whose
civil status was registered as married in the Certificate of Death and Fredie
Lou Mancera Aya-ay, child of the above-mentioned spouses and our
neighbor, refer to one and the same person whose true and correct civil
status SINGLE;
159. The error is a plain oversight on the part of the registering officer;
160. We are not related either by affinity or by consanguinity and that we have
no interest of whatsoever with the above-mentioned persons; and
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 28th day of June,
SHERWIN G. MURILLO ISIDRO O. MISSION

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 28th day of June, 2013 in the City of
Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiants and that I am
________________________________

In The City Of Davao )ss
x------------------------/
Affidavit
I, RAMON S. JARDENICO, of legal age, Filipino, married and a resident of km. 7 matina Pangi,
Davao City, Philippines, after having been sworn to in accordance with law do hereby depose and state
that:
1. I am the original owner of that motorcycle, the particulars of which are as follows:
MAKE/TYPE HONDA
MOTOR NO. XRM17029383
SERIAL/CHASSIS NO. XRM17029383
COLOR RED
PLATE NO. 6040MP
2. I have mortgaged the said motorcycle to Motor One Marketing (mortgagee), Balusong
Matina. Photocopies of the Certificate of Registration and Official Receipt are hereto
attached to form part hereof;
3. I failed however my obligation to the mortgagee, and such that the same was forclosed
in their favor, the Motor One Marketing;
4. I have no more claims of whatsoever with the above-described motorcycle;
5. I am executing this affidavit to attest to the truth of the foregoing averments
IN WITNESS HEREOF, we have hereunto affixed our signatures this 26 th day of June, 2013, in the
RAMON S. JARDENICO
Affiant
SUBSCRIBED AND SWORN TO before me this 26 th day of June, 2013 in the City of Davao,
____________________________________

x------------------------/
Affidavit Of Ownership
I, DENNIS MANGANA LLANERA, of legal age, Filipino, married and a resident of Blk. 3,
Peralta Subd., Tahimik Ave., Bangkal, Davao City, Philippines, after having been sworn to in accordance
6. I am an owner of a motorcycle, the particulars of which are as follows:
MAKE/TYPE HONDA
MOTOR NO. XRM17029383
SERIAL/CHASSIS NO. XRM17029383
COLOR RED
PLATE NO. 6040MP
7. I have gained ownership of the said motorcycle by way of assumption of mortgage
from Motor One Marketing. Certificate of Sale is hereto attached to form part hereof;
8. The said motorcycle was apprehended and impound when the rider JAYNES DONDE
RANCISCO, my househelp, was apprehended for violation of PD 1780 (Concealment
of Deadly Weapon);
9. I am executing this affidavit to attest to the truth of the foregoing averments, and to
submit the same to the Office of the City Prosecutor for whatever purpose this may
serve to my request for the release of my motorcycle; and
10. That I hereby undertake to surrender the same motorcycle if it be needed for the
prosecution of the case mentioned above.
DENNIS M. LLANERA
Affiant
SUBSCRIBED AND SWORN TO before me this 25 th day of June, 2013 in the City of Davao,
____________________________________

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
OF THE HEIRS OF RODRIGO T. PEÑAS
(QUITCLAIM & INDEMNITY)
We, the undersigned HEIRS OF RODRIGO T. PEÑAS, all of legal age, Filipino,
married and residents of S. I. R., Phase II, New Matina, Davao City, Philippines, respectively,
162. We are the heirs of Rodrigo T. Peñas (wife and children) who died
instestate on April 26, 2013 in Bago City, Negros Occidental, without a will;
163. During his lifetime, the deceased left an account at the Bank of the
Philippine Islands with SAVINGS ACCOUNT No. 9446-0841-55 with an
outstanding balance of TWENTY FIVE THOUSAND 0NE HUNDRED FORTY
FOUR PESOS and 81/100 CENTAVOES (P25,144.81);
164. There are no known debts or obligation due against the estate of our
father; We, being of legal age and with full civil capacity to contract, hereby
by these presents, agree to adjudicate extra-judicially among ourselves the
above-mentioned savings account;
165. We, MARVIN JAN C. PEÑAS, CHERRIE MAR P. ALFARO, ROLAND

FEB C. PEÑAS, and CHRISTINE TOBY C. PEÑAS, surviving children and
legal heirs of Rodrigo T. Peñas hereby waive and/or relinguish our respective
rights and interest over the said SAVINGS ACCOUNT unto and in favor of
our mother MAJELLA C. PEÑAS;
166. That we are executing this affidavit with our own free act, free from
intimidation, purposely to submit the same to the Bank of the Philippine
Islands in compliance with the requirement for our mother to claim/withdraw
amount (all) from the above-mentioned SAVINGS ACCOUNT.

______________________ in the City of Davao, Philippines.
MARVIN JAN C. PEÑAS CHERRIE MAR P. ALFARO

Affiant Affiant
ROLAND FEB C. PEÑAS CHRISTINE TOBY C. PEÑAS

Affiant Affiant
MAJELLA C. PEÑAS
Affiant
SUBSCRIBED AND SWORN to before me this ______________________, in the

City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiants and that I
am satisfied that they voluntarily executed and understood the foregoing affidavit.
Doc. No. __________

Page No. __________
Book No. __________
Series of 2013.

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, VIVIAN LIGAN and MARIVIC COLANO, both of legal age, Filipino, married and
residents of Yakal St., Kabacan, Matina, Brgy. 76-A, Davao City, Philippines, respectively, after
having been sworn to in accordance with law do hereby depose and state that:
167. We personally know the person of CARLITO PIÑERO who was

married to Veronica Unabia ON March 25, 1993. Their marriage was
solemnized the the civil courts of Davao City;
168. In their Marriage Contract however, the family name of the husband is
incorrectly registered as PEÑERO. It should have been PIÑERO to
conform with his true and correct family name as shown in his Certificate of
Live Birth;
169. We hereby declare under oath that Carlito Peñero per Marriage
Contract and Carlito Piñero, our neighbor, refer to one and the same
person whose true and correct name is CARLITO TABARCON PIÑERO;
170. The error is a plain oversight on the part of the registering officer;
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 20th day of June,
VIVIAN LIGAN MARIVIC COLANO

Affiant Affiant
________________________________

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, FERMIN ENOCH and ARSENIO MASAGLANG, both of legal age, Filipino,
married and residents of Baguio Proper, Baguio District, Davao City, Philippines, respectively,
173. We personally know the person of the late SARENAS ONSE who is the
husband of Fidela Laid Onse. He died last June 8, 2013;
174. In their Marriage Contract, the family name of the mother of the deceased
was incorrectly registered as BACAWAN. It should have been WAYAN to
conform with the true and correct family name of EGAY WAYAN;
175. We hereby declare under oath that EGAY BACAWAN per Marriage
Contract of spouses Sarenas Onse and Fidela Laid Onse and EGAY
WAYAN, our neighbor, refer to one and the same person whose true name
is EGAY WAYAN ONSE;
176. The error is a plain oversight and could be attributed to the person giving
the information or to the registering officer as the couples were indigenous
people;
averments.

______________________ in the City of Davao, Philippines.
FERMIN ENOCH ARSENIO MASAGLANG

Affiant Affiant
SUBSCRIBED AND SWORN to before me this ______________________, in the

am satisfied that they voluntarily executed and understood the foregoing affidavit.
________________________________
x-------------------/
Affidavit Of Loss
I, MANUEL D. DIEZ, of legal age, Filipino, married and a resident of Blk. 55,
Lot 1, Country Homes, Cabantian, Davao City, Philippines, after having been sworn
20. I am an owner of a duly registered YAMAHA motorcycle

bearing Plate Number YF8807;
21. Upon reaching my place of residence last night, at around

8:00 o’clock in the evening, I discovered the loss of my wallet
containing important documents, including the Official Receipt of
my motorcycle;
22. Furthermore, I likewise discovered that the rear Plate

Number of my motorcycle was lost;
23. Diligent efforts exerted to locate the lost document as

well as the Plate Number proved to no avail;

the foregoing facts and submit the same to the Land
Transportation Office of Davao City to request for a replacement
of the lost Official Receipt and License Plate Number.
IN WITNESS hereof, I have hereunto affixed my signature this ____ t of June,

MANUEL D. DIEZ
Affiant
SUBSCRIBED AND SWORN to before me this ______ day of June, 2013, in the City of
x-------------------/
Affidavit Of Denial
I, ROWENA DOMINGUEZ Y FERNANDEZ, 47 years of age, Filipino, widow

and a resident of km. 3, Upper Bajada, Davao City, Philippines, after having been
25. I intend to secure clearance from the National Bureau of

Investigation (NBI), Davao City, however per record verification
at the bureau a criminal record appears as follows:
Accused ROWENA DOMINGUEZ

CASE NO. 4907-B-92
CRIME ESTAFA
STATUS ARCHIVED 08/25/93
COMPLAINANT JOSIE BORDIOS
26. I vehemently deny being the same person charged of the

crime above-mentioned;
27. Under penalty of law, I hereby declare under oath that I

have no pending case nor have been accused of any crime in my
life;

the foregoing facts and submit the same to the authorities
concerned for whatever purpose this may serve to my intent to
secure certificate of clearance.
IN WITNESS hereof, I have hereunto affixed my signature this 7 th of June,

ROWENA F. DOMINGUEZ
Affiant
SUBSCRIBED AND SWORN to before me this 7 th day of June, 2013, in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied
that the affiant voluntarily executed and understood the foregoing.
____________________________________
x-------------------/
Affidavit Of Assembly
(Sidecar)
We, GUILLERMO JR MAAGMA ALCUIZAR and EMMANUEL PULIDO, of

legal age, Filipino, married and a resident of Purok 4, Saavedra St., Toril, Davao
City, Philippines, after having been sworn to in accordance with law do hereby
29. I, GUILLERMO JR MAAGMA ALCUIZAR, am an owner

of a duly registered motorcycle, the particulars of which are as
follows:
Make/Type/Model HONDA MOTORCYCLE

Motor/Engine No. KWY00E084249
Chassis No. KWY10084246
Fuel Gas
Plate No. 6065LT
30. I intended to convert my “single” motorcycle to tricycle to

earn a living. As such, sometime in the month of August 2012, I
contracted my neighbor, EMMANUEL PULIDO, an automotive
body builder, to assemble a sidecar for my motorcycle;
31. I, EMMANUEL PULIDO, had been contracted by Mr.

Guillermo M. Alcuizar, Jr., to assemble a sidecar for his Honda
motorcycle;
32. The sidecar was assembled and mounted on the

motorcycle on the first week of September 2012;
33. I hereby certify that the motorcycle with sidecar is

roadworthy;
34. I (GUILLERMO JR MAAGMA ALCUIZAR) failed to

registered the sidecar for financial reason; and
35. That we are executing this affidavit to attest to the truth

of the foregoing facts for purposes of registration.

___________________________, in the City of Davao, Philippines.
GUILLERMO M. ALCUIZAR, JR. EMMANUEL PULIDO
Affiant Affiant
SUBSCRIBED AND SWORN to before me this __________________________, in the

am satisfied that the affiants voluntarily executed and understood the foregoing.
________________________________________

x-------------------/
Affidavit Of Loss
I, DR. JAY KARLOU P. SANCHEZ I, of legal age, Filipino, single and a

resident of Matina, Davao City, Philippines, after having been sworn to in
36. I, a Philippines Passport holder, with Passport No XX

1657142, had my passport renewed sometime in January 2013;
37. In view of my renewal, Department of Foreign Affairs

Consular Office Davao City, issued to me a receipt as proof of
payment;
38. However, the said receipt was lost in my possession and

found;

the foregoing facts and submit the same to the DFA, Davao City,
for whatever purpose this may serve for the release of my new
passport.
IN WITNESS hereof, I have hereunto affixed my signature this 1 st of June,

DR. JAY KARLOU P. SANCHEZ I

Affiant
SUBSCRIBED AND SWORN to before me this 1st day of June, 2013, in the City of Davao,
x-------------------/
Affidavit Of Loss
I, FELICIDAD C. CANONIGO, of legal age, Filipino, married and a resident

of 408 Talomo, Davao City, Philippines, after having been sworn to in accordance
40. I am the heir of Pedro Clavano and Crecenciana

Labadesos Clavano;
41. the decedents are the registered own of a parcel of land

situated at Maigo, Lanao del Norte, the same being evidenced
and bounded in Certificate of Title No. T-1169104 of the
Register of Deeds for Lanao del Norte;
42. the Certificate of title mentioned above however was

misplaced in my place of residence and despite diligent efforts
exerted to locate, the same could not be found, and deemed
lost, beyond recovery;
43. the lost title was not sold, alienated, mortgage or in any
manner encumbered to another or third party;

the foregoing facts purposely to submit the same to the
Registered of Deeds for Lanao del Norte request for replacement
of the aforementioned lost Certificate of Title.
IN WITNESS hereof, I have hereunto affixed my signature this 31 st of May,

FELICIDAD C. CANONIGO
Affiant
SUBSCRIBED AND SWORN to before me this 31 st day of May, 2013, in the City of Davao,
____________________________

x-------------------/
Affidavit Of Loss
I, DR. JANET CELESTIAL YAMYAMIN, of legal age, Filipino, single and a

resident of New Matina, Riverside, Davao City, Philippines, after having been sworn
45. Being a taxpayer, I was issued Tax Identification Number

(TIN) by the Bureau of Internal Revenue;
46. Unfortunately, my said TIN was lost in my possession and

found;

the foregoing facts purposely to request for replacement of my
lost TIN from the Bureau of Internal Revenue.
IN WITNESS hereof, I have hereunto affixed my signature this 31 st of May,

DR. JANET C. YAMYAMIN

Affiant
SUBSCRIBED AND SWORN to before me this 31 st day of May, 2013, in the City of Davao,
In the City of Davao )ss.
x-------------------/
Affidavit
I, DANIEL CEELINE SUELTO RAMONAL, of legal age, Filipino, single and a

resident of Blk. 47, Lot 16, Gulf View, Bago Aplaya, Talomo District, Davao City,
Philippines, after having been sworn to in accordance with law do hereby depose
and state that:
48. I am a graduate of Bachelor of Arts in Speech

Communication at the Unibersidad Ng Pilipinas. I graduated in
the school year 2002;
49. I have a Certificate of Information (CAV No. 3235, Series

of 2005) issued by the Commission on Higher Education,
Cordillera Administrative Region, signed by Ms. Presda T.
Panangwe;
50. the middle name (Initial S) on said academic document

stands for SUELTO as appearing on Passport No. EB 6747305
issued on 13 November 12 in Department of foreign Affairs,
Cagayan de Oro, Philippines, with expiration date until 12
November 2017;
51. the said passport is new; and

the foregoing facts.

DANIEL CEELINE S. RAMONAL

Affiant
________________________________________
Doc. No. ____________

Page No. ____________
Book No. ____________
Series of 2012.

x-------------------/
I, MERCEDITA MONSALE Y LEBRIA, of legal age, Filipino, married and a

resident of Purok 10, Kabacan, Bucana, Davao City, Philippines, after having been
53. I am engaged in manufacturing of Tart and Durian Candy

making, operating under business name & style “JUBY & NENE
Homemade Durian Delicacies” and Business Permit No. B-
71850-0;
54. As such, I have OFFICIAL RECEIPTS (OR’s) printed

and registered at the Bureau of Internal Revenue (BIR);
55. Actually, it was my BOOKKEEPER who facilitates the

renewal of my Business Permit and the printing and registration
of my OR’s;
56. As my OR’s were about to be consumed, I went to the

BIR to request for requirements for printing of OR’s. However,
my business record was examined through the BIR computer, it
was found out that the printing press (RYMON’S PRINT
HAUS), which was supposed to be the printer of my OR’s is
not registered. Therefore, my OR’s are also not registered;
57. I hereby declare under oath that it was my

BOOKKEEPER, Francisca R. Lofranco, failed to register my
OFFICIAL RECEIPTS, despite my payment to her for her labor
to renew my business permit and prepare OR’s through their
printing business; and

the foregoing facts purposely to explain the non-registration of
my OFFICIAL RECEIPT used in my business.
IN WITNESS hereof, I have hereunto affixed my signature this 29 th of May,

MERCEDITA L. MONSALE
Affiant
SUBSCRIBED AND SWORN to before me this 29 th day of May, 2013, in the City of Davao,
________________________________________

x-------------------/
I, JOSE ALVARO FRANCISCO GUTIERREZ, 19 years of age,

Filipino/Spanish, single and a resident of Bago Aplaya, Davao City, Philippines, after
59. I have applied to renew my Philippine Passport, however,

my record with the Department of Foreign Affairs shows that I
am also a holder of a Spanish Passport;
60. As such, I was required to explain the reason of my

possession of another passport;
61. I was able to acquire Spanish Passport being a Spanish

Citizen. I possess dual citizenship as Filipino and Spanish. I have
acquired Filipino Citizenship being a natural born Filipino. My
mother, Judith Francisco, is a Filipino Citizen and father, Jose
Mejorada Gutierrez, possessing dual citizenship (Filipino and
Spanish);
62. Likewise, my father acquired Spanish Citizenship because

his father was a Spanish;
the foregoing facts purposely to explain my possession of
Spanish Passport.

JOSE ALVARO F. GUTIERREZ

Affiant
________________________________________

x-------------------/
I, JOSE NICOLO FRANCISCO GUTIERREZ, 22 years of age,

Filipino/Spanish, single and a resident of Bago Aplaya, Davao City, Philippines, after
64. I have applied to renew my Philippine Passport, however,

my record with the Department of Foreign Affairs shows that I
am also a holder of a Spanish Passport;
65. As such, I was required to explain the reason of my

possession of another passport;
66. I was able to acquire Spanish Passport being a Spanish

Citizen. I possess dual citizenship as Filipino and Spanish. I have
acquired Filipino Citizenship being a natural born Filipino. My
mother, Judith Francisco, is a Filipino Citizen and father, Jose
Mejorada Gutierrez, possessing dual citizenship (Filipino and
Spanish);
67. Likewise, my father acquired Spanish Citizenship because

his father was a Spanish;
the foregoing facts purposely to explain my possession of
Spanish Passport.

JOSE NICOLO F. GUTIERREZ

Affiant
________________________________________

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, JO ANN C. OBOC and ROMEO S. NAVARRO, both of legal age, Filipino, married
and residents of Santan St., Mintal, Tugbok District, Davao City, Philippines, respectively, after
179. We personally know the person of MERLIE AGON CLARO who is the
wife of Eduardo C. Claro;
180. She is the child of spouses Federico L. Agon and Magdalena Ingay who
was born on November 6, 1971 in Davao City;
181. She intends to apply for work abroad, however, her Certificate of Live
Birth shows discrepancy on her given name. Her given name registered in
her Certificate of Live Birth is MERLY while in her marriage Contract and
other personal documents, her name registered is MERLIE;
182. We hereby declare under oath that MERLY AGON CLARO per
Certificate of Live birth and MERLIE AGON CLARO per Marriage Contract
and all other personal documents, refer to one and the same person whose
true name per NSO authenticated Certificate of Live Birth is MERLY AGON
CLARO;
no interest of whatsoever with the above-mentioned persons; AND
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 21st day of May,
JO ANN C. OBOC ROMEO S. NAVARRO

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 21 st day of May, 2013, in the City of
________________________________

x-------------------/
Affidavit Of Loss
I, VINCENT BRENOLD CERVANTES GIRON, 19 years of age, Filipino,

single and a resident of San Lorenzo Village, Puan, Davao City, Philippines, after
69. I am a bonafide student of the University of Southeastern

Philippines (USEP);
70. As such, I was issued University Identification Card (USEP
ID);
71. My said USEP ID however was lost in my possession and

found;
72. My lost ID was not confiscated nor revoked; and

the foregoing facts purposely to apprise the USEP Administration
Office for whatever purpose this may serve.

VINCENT BRENOLD C. GIRON

Affiant
________________________________________

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, ANNALISSA M. IRANON and JOCELYN L. BATULA, both of legal age, Filipino,
married and residents of Cabantian, Buhangin and Jasmin Ali, San Pedro Extension, Davao
City, Philippines, respectively, after having been sworn to in accordance with law do hereby
185. We personally know the person of PILAR BERTINA TALEON

SEPULVEDA who is the wife of Victor C. Sepulveda;
186. Recently, she has submitted herself for treatment at Brokenshire

Integrated Health Ministries, Inc.;
187. Her husband is a member of Philippine Health Insurance Corporation

(Philhealth), and being a beneficiary, she intends to avail Philhealth benefits;
188. Records of her husband at the Philhealth office however shows that her
given name registered is PILAR only. It should have been PILAR
BERTINA to conform with her true name as could be gleaned in her
Certificate of Live Birth and all other personal documents;
189. We hereby declare under oath that PILAR, Listed as wife and
beneficiary of Victor Sepulveda per Philhealth record and PILAR
BERTINA, our neighbor refer to one and the same person whose true
name is PILAR BERTINA TALEON SEPULVEDA;
190. we are not related either by affinity or by consanguinity and that we have
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 25th day of April,
AMERICUS S. YANONG DINA FE C. LISTON

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 25th day of April, 2013, in the City of
satisfied that the affiants voluntarily executed and understood the foregoing affidavit.
________________________________

x------------------------/
Affidavit
I, MERRY GRACE M. CULABA, of legal age, Filipino, married and a resident of Phase
4, Lot 42, Block 70 Deca Homes, Mintal, Tugbok District, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and say that:
6. I am the employer of MARICEL N. BUALAN, who is nineteen (19) years old;
7. She has been working as my household keeper since March 17, 2013 up to
the present;
8. She is stay-in and under my guardianship;
9. That I am executing this affidavit to apprise the authorities concerned for

enrollment purposes under Sunday High School Education Program
(SHSEP)
IN WITNESS hereof, I have hereunto affixed my signature this 15 th of May, 2013, in the
MERRY GRACE M. CULABA

Affiant
SUBSCRIBED AND SWORN to before me this 15th day of May, 2013 at Davao City,
that he voluntarily executed and understood the foregoing affidavit thereof.
___________________________________
Notary Public

x------------------------/
We, GORGIE V. ABEJUELA, NORMALITA T. WALES and LORGIE J. ASUNCION, all

of legal age, Filipino, married and residents of Mintal, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and say that:
10. We are the Chairman, Poll Clerk and Third Member, respectively,
composing the Board of Inspectors (BEI), of Precinct No. 1042 situated at
Mintal Elementary School, Mintal, Tugbok District, Davao City;
11. After the 2013 Election, following Section 54 of the General Instruction
from the COMELEC, particularly Section a): Placing inside the Ballot Box the
Sealed Envelopes, ER, Minutes, half of torn unused ballots, and Rejected
Ballots;
12. After sealing the Ballot Box for disposition, we discovered that a printed
instruction for the OFFICIAL BALLOTS was written at the back of the
ENVELOPES;
13. As such, we failed to place the ENVELOPES containing the OFFICIAL

BALLOTS inside the BALLOT BOX;
14. We endorsed the OFFICIAL BALLOTS at the COMELEC at Sangguniang

Panlunsod, however, we were made to explain why the ENVELOPES
containing the Official Ballots were not place inside the Ballot Box;
15. The reason for its omission was not deliberate but was a plain oversight
on our part;
16. That we are executing this affidavit to apprise the Commission on Election
of the foregoing averments.
IN WITNESS hereof, I have hereunto affixed my signature this 14 th of May, 2013, in the
GORGIE V. ABEJUELA NORMALITA T. WALES

Affiant Affiant
LORGIE J. ASUNCION
Affiant
SUBSCRIBED AND SWORN to before me this 14 th of May, 2013, at Davao City,

______________________________________
Notary Public

x------------------------/
I, CHARISSE B. VILLAFLORES, R. N., of legal age, Filipino, single and a resident of
362 Garcia Abella, Digos City, Philippines, after having been duly sworn to in accordance with
law, do hereby depose and say that:
17. I was a trainee nurse from March 10, 2006 to March 13, 2007 at the
Davao Medical Center, Bajada, Davao City;
18. I was then employed as Staff Nurse in Gurayat General Hospital, under
the Ministry of Health from November 14, 2007 to till November 1, 2008,
assigned at the Pediatric Intensive Care Unit;
19. I was then employed as Staff Nurse from February 24, 2009 to June 27,
2011 at Al Inma Medical Services, Riyadh, Kingdom of Saudi Arabia;
20. I was employed as Staff Nurse from April 1, 2012 to April 3, 2013 at
Kayden Blaise Birthing Home, Digos City, Philippines;
21. Having been employed with the said hospitals/clinic, I was issued the
following Certificates:
a) Certification of Training dated March 13, 2007 issued by the Davao

Medical Center;
b) Certification of employment dated November 1, 2008 issued by the
Gurayat General Hospital;
c) Certification of employment dated June 11, 2011 issued by Al Inma
Medical Services; and
d) Certification of employment dated April 27, 2013 issued by Kayden Blaise
Birthing Home;
22. I hereby declare under oath that the above-mentioned documents are
faithful reproduction of the original National Certificates and the same are
true and correct to the best of my knowledge and belief; and
23. That I am executing this affidavit to apprise the authorities concerned of

the veracity of the foregoing averments.
IN WITNESS hereof, I have hereunto affixed my signature this 2 nd of May, 2013, in the
CHARISSE B. VILLAFLORES, R. N.
Affiant
SUBSCRIBED AND SWORN to before me this 2 nd day of May, 2013 at Davao City,
______________________________________
Notary Public
Doc. No. _________
Page No. _________
Book No. _________
Series of 2013
x-------------------/
I, NEIL MICHAEL B. SALA-AN, of legal age, Filipino, single and a

resident of 362 Garcia Abella, Digos City, Philippines, after having been duly
24. I was employed as General Nurse under the Medical

Department of Dannah Al-Khozama for the period from June
2010 to May 2012;
25. Thereafter, I was employed as Staff Nurse at Kayden

Blaise Birthing Home from July 1, 2012 to April 20, 2013;
26. Having been employed with the said company and clinic, I
was issued the following Certificates:
e) Certification of employment dated May 11, 2012 issued by

Dannah Al-Khozama for Trading Est.; and
f) Certification of employment dated April 27, 2013 issued by
Kayden Blaise Birthing Home;
27. I hereby declare under oath that the above-mentioned

documents are faithful reproduction of the original National
Certificates and the same are true and correct to the best of
my knowledge and belief; and
28. That I am executing this affidavit to apprise the authorities

concerned of the veracity of the foregoing averments.
IN WITNESS hereof, I have hereunto affixed my signature this 2 nd of

May, 2013, in the City of Davao, Philippines.
NEIL MICHAEL B. SALA-AN

Affiant
SUBSCRIBED AND SWORN to before me this 2 nd day of May, 2013 at Davao City,
Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am
satisfied that he voluntarily executed and understood the foregoing affidavit thereof.
______________________________________
Notary Public
Doc. No. _________
Page No. _________
Book No. _________
Series of 2013
x-------------------/
I, PEARL ANGEL L. OCIONES, of legal age, Filipino, single and a

resident of Lower Madapo Hills, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and say that:
29. Having completed the two (2)-year course in Bachelor in

Science in Hotel and Restaurant Management, I was awarded
a NATIONAL CERTIFICATE II by the Technical Education
and Skills Development Authority;
30. I am now an applicant for overseas employment;
31. I hereby declare under oath that the above-mentioned

document I have submitted to support my application are
faithful reproduction of the original National Certificate II and
the same is true and correct to the best of my knowledge and
belief; and
32. That I am executing this affidavit to apprise the authorities

concerned of the veracity of the foregoing averments.

April, 2013, in the City of Davao, Philippines.
PEARL ANGEL L. OCIONES

Affiant
SUBSCRIBED AND SWORN to before me this 26 th day of April, 2013 at Davao

City, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am
______________________________________
Notary Public
Doc. No. _________

Page No. _________
Book No. _________
Series of 2013
In Davao City )ss
x------------------------/
Affidavit Of Correction
I, PILAR BERTINA TALEON SEPULVEDA, of legal age, Filipino, married and

residents of 16 San Miguel St., Skyline Village, Catalunan Grande, Davao City, Philippines,
192. I am the wife of Victor C. Sepulveda;
193. From February 24, 2013 to March 01, 2013, I was confined at
Brokenshire Integrated Health Ministries, Inc.;
194. My husband is a member of Philippine Health Insurance Corporation

(Philhealth), and being a beneficiary, I intend to avail of the Philhealth
benefits;
195. However, record of my husband at the Philhealth office shows that my

given name is registered only as PILAR. It should have been PILAR
BERTINA as appearing in my Certificate of Live Birth, SSS record and all of
my personal documents;
196. I hereby declare under oath that PILAR, as wife and beneficiary of
Victor Sepulveda per Philhealth record and PILAR BERTINA, refer to the
undersigned affiant; and
averments and to submit the same to the Brokenshire Integrated health
Ministries, Inc., for the purpose of correcting my name in my medical record,
particularly in the Medical Certificate and Patient Statement of Account. from
PILAR BERTINA TALEON SEPULVEDA to PILAR TALEON
SEPULVEDA.
IN WITNESS HEREOF, I have hereunto affixed my signature this 25 th day of April,

PILAR BERTINA T. SEPULVEDA

Affiant
______________________________________

In Davao City )ss
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and DINA FE C. LISTON, both of legal age, Filipino,
married/single and residents of Green Meadows Subd., Brgy. Sto. Niño, Tugbok District, and R.
Castillo St., Agdao, Davao City, Philippines, respectively, after having been sworn to in
198. We personally know the person of PILAR BERTINA TALEON

SEPULVEDA who is the wife of Victor C. Sepulveda;
199. Recently, she has submitted herself for treatment at Brokenshire

Integrated Health Ministries, Inc.;
200. Her husband is a member of Philippine Health Insurance Corporation

(Philhealth), and being a beneficiary, she intends to avail Philhealth benefits;
201. Records of her husband at the Philhealth office however shows that her
given name registered is PILAR only. It should have been PILAR
BERTINA to conform with her true name as could be gleaned in her
Certificate of Live Birth and all other personal documents;
202. We hereby declare under oath that PILAR, Listed as wife and
beneficiary of Victor Sepulveda per Philhealth record and PILAR
BERTINA, our neighbor refer to one and the same person whose true
name is PILAR BERTINA TALEON SEPULVEDA;
203. we are not related either by affinity or by consanguinity and that we have
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 25th day of April,
AMERICUS S. YANONG DINA FE C. LISTON

Affiant Affiant
________________________________

x-------------------/
I, ULDARICO H. HERCEDA, of legal age, Filipino, married and a resident

of 01 Lilac St., Ph4-A, El Rio Vista Village, Bacaca, Brgy. 19-B, Davao City,
33. That I am a holder of Professional Driver License No. LO2-

94-098571;
34. That at about 12:50 in the afternoon of April 22, 2013,

while driving my INOVA SUB with Plate No. LGK 497 at Torres
St., it figured vehicular incident with another vehicle,
Mitsubishi Sedan bearing Plate No. PLK 527, resulting to both
vehicles to incur slight damages;
35. That the incident was amicably settled. In fact, there was
no case filed regarding the incident;

the foregoing averments purposely to submit the same to the
Land Transportation Office (LTO), Davao City, to request for
the release of my license; and
37. That I will undertake to surrender my license should a

complaint be filed pertaining to the same vehicular incident
mentioned above.

April, 2013, in the City of Davao, Philippines.
ULDARICO H. HERCEDA
Affiant
SUBSCRIBED AND SWORN to before me this 24 th day of April, 2013 at Davao
_______________________________________

x-------------------/
Affidavit Of Loss
I, FEDRICO LLERA BADAYOS, of legal age, Filipino, married to Phoebe

Reyes Badayos and a resident of Bolcan St., Cabaguio, Agdao, Davao City,
Philippines, after having been sworn to in accordance with law do hereby depose
and state that:
74. I am an owner of a duly registered motor vehicle, the

particulars of which are as follows:
Make/Type/Model SUZUKI Pick-up

Motor/Engine No. F6A-6360583
Chassis No. DD51T-423226
Fuel Gas
Plate No. MEA165
75. Unfortunately, the Official Receipt and Certificate of

Registration of my said vehicle was misplaced in my house and
despite diligent efforts exerted the same proved to no avail;
76. The lost documents were not confiscated nor revoked in

violation of Traffic Rules and Regulations;
77. I am executing this affidavit to attest to the truth of the

foregoing facts purposely to apprise the authorities concerned to
request its replacement.
IN WITNESS hereof, I have hereunto affixed my signature this 16 th of April,

FEDRICO L. BADAYOS
Affiant
SUBSCRIBED AND SWORN to before me this 15 th day of April, 2013, in the City of
________________________________________
A NON- EXCLUSIVE
A U T H O R I T Y TO S A L E
TO WHOM IT MAY CONCERN;
This authorizes Allan Lumanog, Eufemia O. Baluran, Carmencita Te Omalga, Juvy B.

Castañeda, Primitiva Fercol and Engr. Cader Aragat, to negotiate/transact for the sale of my/
our property described here in below;
The Property : AMLO REALTY DEV’T. CORPORATION

TITLE NO : T-49962
LOCATION : POBLACION, STA.CRUZ, DAVAO DEL SUR
PRICE : P1,000.00/SQ.M.
Terms and Condition;
Capital gain tax and documentary stamp tax shall be for the account of the seller, attorney’s fee
and other registration of new title shall be for the account of the buyer.
We commit/agree to give them three ( 3 ) percent (%) commission based on the actual
consideration paid by the buyer.
This Authority is non-exclusive and on a 1st come 1st serve basis only and will expire three
months from the date hereof.
Davao City, Philippines, this April 15, 2013
OWNER/SELLER
BY:
MANUEL B. BENDIGO
RAUL B. BENDIGO
CONFORME:
Broker/Agents
_____________________________
_____________________________
_____________________________
_____________________________

In The Municipality of Cantilan )ss
Surigao del Sur . . . . . . . . . . . . . . . )
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, EMEDIO R. SUHIAN and JUAN C. INTANO, both of legal age, Filipino, married
and residents of Purok 2, Panikian, Carrascal, Surigao del Sur, Philippines, respectively, after
a) we personally know the person of spouses JOSE ESPIDIDO

CASTAÑEDA (Jose for short) and NEPOMUCENA BAYONLA
(Nepomucena for short) who were married one June 11, 1962 at the
Roman Catholic Church of Carrascal, surigao del Sur;
b) in their Marriage Contract, the middle name of the mother of Jose is

correctly registered as ESPIDO. It should have been ESPIDIDO;
c) during their marital union, the spouses Jose and NEPOMUCENA
were blessed with children and among them is DANILO BAYONLA
CASTAÑEDA (Danilo). Danilo however died of vehicular incident on
November 25, 2012 in Bacolod, Carascal, Surigao del Sur. Thus, the
name of Jose Espidido Castañeda, being the father, was registered
at the Certificate of Death of Danilo;
d) That we hereby declare under oath that the family names ESPIDO,
maiden family name of the mother of Jose E. Castañeda per Marriage
Contract of spouses Jose Castañeda and Nepomucena Bayonla and
ESPIDIDO, middle name of Jose E. Castañeda, per Death Certificate of
Danilo, refer to the middle name of one person, the father of the
deceased Danilo, whose true and correct middle name is ESPIDIDO;
e) That we are not related either by affinity or by consanguinity and that we

have no interest of whatsoever with the above-mentioned persons;
f) That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this _____ day of
April, 2013, in the Municipality of Cantilan, Surigao del Sur, Philippines.
EMEDIO R. SUHIAN JUAN C. INTANO

Affiant Affiant
SUBSCRIBED AND SWORN to before me this ____ day of April, 2013, in the
Municipality of Cantilan, Surigao del Sur, Philippines, and I HEREBY CERTIFY that I have
examined the affiant and that I am satisfied that the affiants voluntarily executed and understood
the foregoing affidavit.
________________________________

x-------------------/
Affidavit Of Loss
I, MARTIN TAGOHANGAN NAMNAMA, 85 years of age, Filipino, married

and a resident of Purok 3, Tibungco, Davao City, Philippines, after having been sworn to in
78. I am a member of the Social Security System (SSS);
79. as such, I was issued SSS Identification Card (SSS ID);

80. The said SSS ID was misplaced in my place of residence
and despite diligent efforts exerted to locate, the same could not
be found;
81. That I have not sold, transferred or in any manner

alienate/encumber the said SSS ID to any other party or
person;

the foregoing facts purposely to apprise the authorities
concerned to request its replacement.
IN WITNESS hereof, I have hereunto affixed my signature this 15 rd of April,

MARTIN T. NAMNAMA
Affiant
SUBSCRIBED AND SWORN to before me this 15 th day of April, 2013, in the City of
________________________________________

x------------------------/
JOINT AFFIDAVIT
(Late Registration)
g) we personally know the person of MARIO LOBERTERNOS JOSE;
h) he is the youngest of the seven (7) children of spouses Austerberta

lugruno Loberternos and Fabian Jose Jose;
i) he was born on March 25, 1969 in Gotamco, Agdao, Davao City;

j) That we both have personal knowledge of the facts above because we
were good neighbors for a long time;
k) That we are not related either by affinity or by consanguinity and that we

l) That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 12th day of April
ANNALISSA M. IRANON JOCELYN L. BATULA

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 12th day of April 2013, in the City of
________________________________

x-------------------/
Affidavit Of Loss
I, MONALISA M. MACAYRA, of legal age, Filipino, widow and a resident of

57-2 S. Artiaga St., Davao City, Philippines, after having been sworn to in accordance with
83. I am a survivor pensioner being the wife of a deceased

Government Service Insurance System (GSIS) member,
ALFREDO S. MACAYRA, SR.;
84. as such, I was issued E-CARD;
85. on or about 27 March 2013, while in Manila, I lost wallet

containing my said E-Card and other important documents, such
as PHILHEALTH CARD and TIN CARD;

alienate/encumber the said cards to another party or person;

the foregoing facts purposely to apprise the authorities
concerned to request for their replacement.

MONALISA M. MACAYRA
Affiant
SUBSCRIBED AND SWORN to before me this 8 th day of April, 2013, in the City of Davao,
________________________________________

x-------------------/
Affidavit Of Loss
I, MONALISA M. MACAYRA, of legal age, Filipino, widow and a resident of

57-2 S. Artiaga St., Davao City, Philippines, after having been sworn to in accordance with
law do hereby depose and state:
88. That for my pledge with M Lhuillier Pawnshop, San Pedro

St. with jewelries as collateral (enumerated below), I was issued
two (2) pawn tickets:
Description/Jewelry Date Pawned Amount

uu) Pulcera Def March 12, 2012 P
22,000.00
vv) Ring w/BS Def Feb 8, 2013 10,000.00
89. That the said pawn tickets were lost in my possession and
diligent efforts exerted to locate, the same could not be found;

alienate/encumber the said pawn tickets to another party or
person;

the foregoing facts purposely to apprise M Lhuillier Pawnshop
and renewal of my pledge.

MONALISA M. MACAYRA
Affiant
SUBSCRIBED AND SWORN to before me this 8 th day of April, 2013, in the City of Davao,
________________________________________

x-------------------/
Affidavit Of Early Renewal

(Re: Philippine Passport)
I, APRIL ANN GEPULLA CALVARA, of legal age, Filipino, married and a
resident of Blk. 7, Lot 9, Kristina Homes, Lubogan, Toril, Davao City, Philippines, after
ww) That I am a holder of Philippine Passport No. XX5515172

issued by the Department of Foreign Affairs, Davao City, on
February 12, 2010 with expiry date on February 11, 2015;
xx) That I intent to travel abroad as contract worker and

probably the job contract would be three (3) years;
yy) That as such, since my passport has only twenty (20)

months before its expiry date, I intend to apply for renewal;
zz)That I am executing this affidavit to attest the truth of the

Department of Foreign Affairs, Davao City Office, to apply for
renewal of my passport.

APRIL ANN G. CALVARA

Affiant
SUBSCRIBED AND SWORN to before me this 3 rd day of April, 2013, in the City of Davao,
________________________________________

x-------------------/
Affidavit Of Loss
I, JESUS RONNIE ALFISCAR ALCARIOTO, of legal age, Filipino, married

and a resident of Mahogany St., Green Meadows Subd., Brgy. Sto. Niño, Tugbok District,
Davao City, Philippines, after having been sworn to in accordance with law do hereby depose
and state:
Union Bank Visa Card

aaa) That I am a holder of a
under Account No. 101160017860;
bbb) That my said card was however lost in my possession and

despite diligent efforts exerted to locate, the same could not
be found;
ccc) That the said visa card was not alienated nor encumbered
in any manner as to attribute of its loss;
ddd) That I am executing this affidavit to attest the truth of the

Union Bank to request a replacement of my lost visa card;
and
eee) That I hereby undertake to surrender the lost visa card if

in the future the same be found.

JESUS RONNIE A. ALCARIOTO

Affiant
SUBSCRIBED AND SWORN to before me this 3 rd day of April, 2013, in the City of Davao,
________________________________________

In The Municipality of Cantilan )ss
Surigao del Sur . . . . . . . . . . . . . . . )
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, EMEDIO R. SUHIAN and JUAN C. INTANO, both of legal age, Filipino, married
and residents of Purok 2, Panikian, Carrascal, surigao del Sur, Philippines, respectively, after
m) That we personally know the person of NEPOMUCENA BAYONLA

CASTAÑEDA who is the wife of Jose E. Castañeda (deceased);
n) That during their marital union, they were blessed with six (6) children and
among them is DANILO BAYONLA CASTAÑEDA who died on vehicular
accident on November 25, 2012 in Carrascal, Surigao del Sur;
o) That Nepomucena B. Castañeda is known to us by her nickname ‘MING’

Castañeda;
p) That we hereby declare under oath that NEPOMUCENA BAYONLA

CASTAÑEDA, the wife of Jose E. Castañeda (deceased) and mother of
Danilo B. Castañeda and MING Castañeda, our neighbor, refer to
one and the same person;
q) That we are not related either by affinity or by consanguinity and that we

r) That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this _____ day of
April, 2013, in the Municipality of Cantilan, Surigao del Sur, Philippines.
EMEDIO R. SUHIAN JUAN C. INTANO

Affiant Affiant
SUBSCRIBED AND SWORN to before me this ____ day of April, 2013, in the
Municipality of Cantilan, Surigao del Sur, Philippines, and I HEREBY CERTIFY that I have
examined the affiant and that I am satisfied that the affiants voluntarily executed and understood
the foregoing affidavit.
________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, NORBERTO MENEL and OSCAR CAÑEDA, both of legal age, Filipino, married
and residents of Purok 13-A, Barangay Ma-a, Davao City, Philippines, respectively, after having
s) That we personally know the person of LEONARDO MALAGANTE

PANDIAN;
t) That he is the child of spouses Fausto Pandian and Angelica Malagante

who was born on March 5, 1953 in Dawis, Digos, Davao del Sur;
u) That his Certificate of Live Birth however shows that his mother’s maiden
family was incorrectly registered as ALACANTE. It should have been
MALAGANTE to conform with his mothers’ true and correct maiden
family name as shown in his other personal record, particularly his
school record and Marriage Contract;
v) That we know for a fact that Angelina Alacante, mother’s maiden

family name of Leonardo Pandian per Certificate of Live Birth and
Angelina Malagante, our neighbor, refer to one and the same person,
whose true and correct maiden family name is Malagante;
w) That we both have personal knowledge of the facts above because we

been good neighbors with the Pandians for a long time in our place of
residence;
x) That we are not related either by affinity or by consanguinity and that we

y) That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 25th day of
March 2013, in the City of Davao, Philippines.
NORBERTO MENEL OSCAR CAÑEDA

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 25 th day of March 2013, in the City of
________________________________

Davao City. . . . . . . . . . . . . . . )s.s.
X--------------------/
REQUEST FOR RELEASE
WITH UNDERTAKING
I, JOYCE MAALAT Y OROCIO, of legal age, Filipino, married and a resident of

Blk. 10, Lot 12, Country Homes, Cabantian, Buhangin, Davao City, Philippines, hereby
depose and say:
1. That I am an owner of a ¼ HP VACUUM PUMP VALUE 1.5 CFM/1.8 CFM #

1-E-215 value at Php9,000.00;
2. That I have legally purchased the said equipment from Merrian Refrigeration
Aircon & Electrical Supply on July 06, 2007, the same being evidence by
Invoice No. 16257 of the said establishment;
3. That the same equipment was stolen by my laborer and sold to another air-
con servicing establishment;
4. That to date, I have not filed any case against my laborer or the buyer of my
equipment;
purposely to request the Station Commander of Police Station 5 for the
release of the above-mentioned equipment as the same is needed to the
operation of my business; and
6. That I hereby undertake to surrender the same equipment if in the future the
same be needed for investigation.
IN WITNESS hereof, I have hereunto affixed my signature this 22 nd of March,

JOYCE O. MAALAT
Affiant
SUBSCRIBED AND SWORN to before me this 22 nd day of March, 2013, in the

foregoing.
________________________________________

x-------------------/
Affidavit Of Low Income
I, SHERYL GALICHA SOLLANO, of legal age, Filipino and a resident of No.

675-4, Governor Sales St., Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and say:
fff) That I am twenty eight (28) years old having been born
on March 29, 1984 in Sto. Tomas, Davao del Norte;
ggg) That I am single but I am seven (7) months pregnant;
hhh) That to date, I am unemployed and a dependent of Eledio

delos Santos, Jr.;
iii) That he is a seaman and has just been employed overseas;
jjj) That I receive a little amount for allotment considering that

he still has his family as dependents;
kkk) That I am executing this affidavit to attest the truth of the

foregoing averments purposely to avail OB-GYNE Surgical
Package.
IN WITNESS hereof, I have hereunto affixed my signature this 20 th of March,

SHERYL G. SOLLANO
Affiant
SUBSCRIBED AND SWORN to before me this 20th day of March, 2013, in the City of
________________________________________

x---------------------------/
Affidavit Of Denial
I, JAMES ALFRED N. GONZALES, of legal age, Filipino, married and a

resident of GSIS Heights, Matina, Davao City, Philippines, after having been duly
lll) That I am an owner of a duly registered motor vehicle,

described as:
Make/Series/Body Type Kia Pride Sedan

Engine Number B3-450576
Chassis Number KNADA2222NA487895
Plate Number GSC443
mmm) That I applied for renewal of the registration of my

said vehicle, however, the Land Transportation Office (LTO)
computer record shows that a motor vehicle from Bacolod
City with the SAME PLATE NUMBER as that of my vehicle
appears to have pending case of obstruction;
nnn) That vehemently deny having committed the said offense

as my vehicle has never been in Bacolod City, Negros
Occidental;
ooo) That I am executing this affidavit to attest the truth of the

Land Transportation Office for whatever purpose this may
serve to my intent for the renewal of registration of the
above-described motor vehicle.

JAMES ALFRED N. GONZALES

Affiant
SUBSCRIBED AND SWORN to before me this 20th day of March, 2013, in the
foregoing.
________________________________________
C E R T I F I C A T I O N
To whom it may concern:
THIS IS TO CERTIFY that Ms. SHERYL GALICHA SOLLANO has been

renting a room of my boarding house situated at No. 675-4, Governor Sales St.,
Davao City since January 7, 2013 for THREE THOUSAND EIGHT (P3,800.00) a
month excluding electric bill.
This is to further certify that she is paying her own electric

consumption.
This certification is being requested by Ms. Sollano for whatever

purpose this may serve her.
Davao City, Philippines, March 20, 2013.
CELSO C. CUNANAN
Owner
x-------------------/
Affidavit Of Low Income
I, SHERYL GALICHA SOLLANO, of legal age, Filipino and a resident of No.

675-4, Governor Sales St., Davao City, Philippines, after having been duly sworn to
ppp) That I am twenty eight (28) years old having been born
on March 29, 1984 in Sto. Tomas, Davao del Norte;
qqq) That I am single but I am seven (7) months pregnant;
rrr) That to date, I am unemployed and a dependent of Eledio

delos Santos, Jr.;
sss) That he is a seaman and has just been employed

overseas;
ttt) That I receive a little amount for allotment considering

that he still has his family as dependents;
uuu) That I am executing this affidavit to attest the truth of the

foregoing averments purposely to avail OB-GYNE Surgical
Package.

SHERYL G. SOLLANO
Affiant
________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and GLORIA DINAH M. VILLA-ABRILLE, both of legal

age, Filipino, married and residents of Mahogany St., Green Meadows Subd., Brgy. Sto. Niño,
Tugbok District and R. Castillo St., Agdao, Davao City, Philippines, respectively, after having
z) That we personally know the spouses FERLYN YBAÑEZ QUIÑON

and RONNIE JESUS ALFISCAR ALCARIOTO;
aa) That they were legally married on December 18, 1992 and with their
marital union, they were blessed with one child, KEZIAH MICAH
QUIÑON ALCARIOTO who was born on May 22, 2000 in Dumanlas,
Davao City;
bb)That the birth of the child Keziah Micah was registered, however, in the
Certificate of Live Birth, the father’s given name was erroneously reflected
as JESUS RONNIE. It should have been RONNIE JESUS to conform
with his true and correct given name;
cc) That we know for a fact that Jesus Ronnie Alfiscar Alcarioto,
father of Keziah Micah Quiñon Alcarioto per Certificate of Live
Birth and Ronnie Jesus Alfiscar Alcarioto, our neighbor, refer to
one and the same person, whose true and correct given name is Ronnie
Jesus;
dd)That we both have personal knowledge of the facts above because we

been good neighbors with the Alcarioto’s for a long time;
ee) That we are not related either by affinity or by consanguinity and that we
ff) That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 21st day of
March 2013, in the City of Davao, Philippines.
AMERICUS S. YANONG DINAH FE C. LISTON

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 21st day of March 2013, in the City of
________________________________
x--------------------------/
Affidavit/Waiver
We, ____________, all of legal age, Filipino and residents of Matina,

vvv) That we are the legitimate heirs of ____________ who died

last March 15, 2013;
www)That the deceased is a member of the Social Security

System;
xxx) That as the deceased is entitled SSS benefits, such as

burial benefits;
yyy) That that we hereby waive our rights and interest over
benefits unto and in favor of our sibling _____________________;
zzz) That we likewise authorize our said sibling to claim and

receive the said burial benefit;
aaaa) That we are executing this affidavit to attest the truth of

the foregoing averments and to submit the same to the
Social Security System, Regional Office XI, Davao City, for the
aforementioned purpose of SSS benefit claim.

JEFFREY G. BARNACHEA
Affiant
SUBSCRIBED AND SWORN to before me this 8 th day of November, 2012,

________________________________________
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, DENNIS L. ELLO and IVY E. VILLALON, both of legal age, Filipino, married and
residents of Marfori and Sasa, Davao City, Philippines, respectively, after having been sworn to
in accordance with law do hereby depose and state:
gg)That we personally know the person of ANGELINA B. NERI who is the

wife of Severo Neri;
hh)That she is the child of spouses Pedro Boysan and Gregoria Pandian
who was born on June 2, 1924 in Davao City;
ii) That she was confined at the Brokenshire Hospital, unfortunately, upon
admission, her date of birth was incorrectly registered at the Hospital
record as MARCH 7, 1932. It should have been June 2, 1924 to
conform with her true and correct date of birth as could be gleaned at her
Member Data Record (MDR) at the office of the Philippine Health
Insurance Corporation.
jj) That Angelina B. Neri whose date of birth is March 7, 1932 per
Brokenshire Hospital record and Angelina B. Neri whose date of birth is
June 2, 1924 per Philhealth record, refer to one and the same person,
referring to ANGELINA B. NERI whose true and correct date of birth is
June 2, 1924;
kk) That we both have personal knowledge of the facts above because we
been good neighbors with the Neri’s for a long time;
ll) That we are not related either by affinity or by consanguinity and that we
mm) That we are executing this affidavit to attest the truth of the
IN WITNESS HEREOF, we have hereunto affixed our signatures this 15th day of March
DENNIS L. ELLO IVY E. VILLALON

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 15th day of March 2013, in the City of
________________________________
x-------------------/
Affidavit
I, WILFREDO PASAOL Y CUTLER, of legal age, Filipino, married and a

resident of Prk. 9, New Loon, Tugbok District, Davao City, Philippines, after having
bbbb) That I am a an owner of a duly registered KIA

BESTA bearing Plate No. LWU-205;
cccc) That I have legally operated the said motor vehicle as

SCHOOL TRANSPORT SERVICE under LTFRB issued
FRANCHISE under Case No. XI-00167;
dddd) That I personally operate the said school

transportation service;
eeee)That I am executing this affidavit to attest the truth of the

Social Security System (SSS) as a requirement to secure
Certificate of Compliance.

WILFREDO C. PASAOL
Affiant
________________________________________
x-------------------/
Affidavit Of Loss
I, WILFREDO PASAOL Y CUTLER, of legal age, Filipino, married and a

resident of Prk. 9, New Loon, Tugbok District, Davao City, Philippines, after having
ffff) That I am a holder of FRANCHISE for SCHOOL

TRANSPORT SERVICE with CASE NO. 2006-00167 issued
by the Land Transportation Franchising & Regulatory Board
(LTFRB), Regional Office XI, Davao City;
gggg) That I tried to claim the copy of my FRANCHISE at

the LTFRB, however, per verification in the said office my
copy was already released
hhhh) That I tried to follow-up the whereabouts of the

copy of my franchise at the office of my lawyer, however, the
same could not produce the said document because their
office files was destroyed by flood waters;
iiii) That I am executing this affidavit to attest the truth of the

LTFRB Regional Office XI for whatever purpose this may
serve to my intent to be issued copy of my franchise.

WILFREDO C. PASAOL
Affiant
________________________________________
x-------------------/
Affidavit Of Loss
I, FELITO MAHINAY Y LEGASPINA, of legal age, Filipino, married and a

resident of San Roque Village, Doña Paz, Sasa, Davao City, Philippines, after having
jjjj) That I am a the father of KLYNE ADRIELLE T.

MAHINAY who is eight (8)-year old Grade II pupil of Doña
Pilar Learning Center at Doña Pilar, Sasa, Davao City;
kkkk) That he was issued School Identification Card (School

ID);
llll) That the said School ID was lost in my child’s possession

while he was in school;
mmmm) That diligent efforts exerted to locate the lost

School ID proved to no avail;
nnnn) That I am executing this affidavit to attest the truth

of the foregoing averments purposely to submit the same to
the School Administration Office of Doña Paz Learning School
for whatever purpose this may serve.
oooo)That I hereby undertake to return/surrender the lost

School ID if the same be found in the future.

FELITO L. MAHINAY
Affiant
________________________________________
x-------------------/
Affidavit Of Retirement
Of Business Permit
I, ABEL ROSAL Y VILLALUNA, of legal age, Filipino, married and a

resident of Hope St., Don Julian Village, Ma-a, Davao City, Philippines, after
say:
pppp) That I am an operator of business for General

Merchandise, operating under Business Permit No. B-
82831-1 with business address at my given address;
qqqq) That the said Business Permit was acquired

sometime in 2008;
rrrr) That unfortunately, because of constant overflow

from the Davao River which caused me considerable
loss of capital, I ceased operating the said business
since 2008;
ssss) That I am executing this affidavit to attest to the

truth of the foregoing averments and to submit the
same to the Business Bureau of the City Mayor’s Office
for whatever purpose this may serve to my intent to
retire my business permit.

March, 2013, in the City of Davao, Philippines.
ABEL V. ROSAL
Affiant
SUBSCRIBED AND SWORN to before me this 13 th day of March, 2013 at Davao

satisfied that he had voluntarily executed and understood the foregoing affidavit
thereof.
_______________________________________
x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AMERICUS S. YANONG and JOCELYN L. BATULA, both of legal age, Filipino,
married and residents of Green Meadows Subd., Brgy. Sto. Niño, Tugbok District and Jasmin
Ali, San Pedro Extension, Davao City, Philippines, respectively, after having been sworn to in
accordance with law do hereby depose and state:
nn)That we personally know the person of MARIZA MORENO ARNALDO;
oo)That she is the child of spouses Socorro Moreno and Vicente Arnaldo
who was born February 6, 1966 in Davao Oriental;
pp)That she is the common-law wife of Ruben Sarenas. They have cohabited
each other sometime in 1990;
qq)That as such, in some of her documents, Mariza Moreno Arnaldo use

and/or registered SARENAS as her family name
rr) That we know for a fact that Mariza Moreno Arnaldo and Mariza Arnaldo
Sarenas or Mariza Sarenas refer to one and the same person, referring to
the above-mentioned person who is the common-law wife of Mr. Ruben
Sarenas;
ss) That we both have personal knowledge of the facts above because we
been good neighbors with the Sarenas’ for a long time;
tt) That we are not related either by affinity or by consanguinity and that we
uu)That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 8 th day of March
AMERICUS S. YANONG JOCELYN L. BATULA

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 8th day of March 2013, in the City of
________________________________
x-------------------/
I, BARBETTE LIM Y MISSION, of legal age, Filipino, married and a

resident of Davao City, Philippines, after having been duly sworn to in
tttt) That I am the private complainant NPS DOCKET NO.

XI-02-INV-13-C-______________ for ROBBERY against
TITONG WARADJI and GOYA BAWA;
uuuu) That among the items recovered by Police

Station 6 in connection with the above-mentioned case
are the following items:
One (1) unit BLACKBERRY CELLULAR PHONE

One (1) unit LENOVO CELLULAR PHONE
METROBANK ATM
vvvv) That I am respectfully requesting the release to my custody

the above itmes as the same are necessary for the undersigned;
wwww) That in connection therewith, I hereby undertake to

produce the same before the Office of the City Prosecutor or
before the court when so required;
xxxx) That I have caused the same to be photographed and

certified by the police station property/evidence custodian as
accurately representing the same;
yyyy) That I am executing this affidavit to attest to the

same to the authorities concerned for whatever purpose
this may serve to my intent to take custody of the items
mentioned above.

march, 2013, in the City of Davao, Philippines.
BARBETTE M. LIM
Owner/Requesting Party
SUBSCRIBED AND SWORN to before me this 7 th day of March, 2013 at Davao

satisfied that she had voluntarily executed and understood the foregoing affidavit
thereof.
_______________________________________

x-------------------/
Affidavit Of Loss
I, EVANGELINE SABEJON Y SUCO, of legal age, Filipino, married and with

address at c/o Stall No. 25, DCOTT, Ecoland, Matina, Davao City, Philippines, after
zzzz) That I am a member of AGDAO MULTI-PURPOSE

COOPERATIVE, San Pedro Branch;
aaaaa) That as such, I was issued PASSBOOKS:

MORTUARY AND TRUST FUND; SHARE CAPITAL
PASSBOK and SAVINGS ACCOUNT PASSBOOK;
bbbbb) That diligent efforts exerted to locate the missing

passbooks proved to no avail;
ccccc) That I am executing this affidavit to attest the truth

the office of the AGDAO MULTI-PURPOSE COOPERATIVE,
San Pedro Branch to request for the replacement of the lost
passbooks; and
ddddd) That I hereby undertake to surrender the said lost

passbooks if the same be found in the future.
IN WITNESS hereof, I have hereunto affixed my signature this 7 th of march,

EVANGELINE S. SABEJON
Affiant
________________________________________

x--------------------------/
Affidavit Of Authorization
I, RICARDO M. LUMANAS, of legal age, Filipino, married and a resident

of 09 Casilak, Bucana, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and say:
eeeee) That I was employed by the Bureau of Customs,

Port of Davao, as Special Agent I;
fffff) That I had retired from the service effective September

17, 2011;
ggggg) That I have filed my retirement benefits/claims with

my employer, the Bureau of Customs;
hhhhh) That I hereby authorize my said employer to deduct

all my financial obligations;
iiiii) That I am executing this affidavit to attest with my own

free will purposely to submit the same to the Bureau of
Customs, Port of Davao, in compliance with the requirement
for my retirement/benefit claim.
IN WITNESS hereof, I have hereunto affixed my signature this ______ day of

February, 2013, in the City of Davao, Philippines.
RICARDO M. LUMANAS
Affiant
SUBSCRIBED AND SWORN to before me this ________ day of February,

2013, in the City of Davao, Philippines, and I HEREBY CERTIFY that I have
examined the affiant and that I am satisfied that the affiant voluntarily
executed and understood the foregoing.
________________________________________

x--------------------------/
Affidavit Of Loss
I, MARIA ANNY G. YANONG, of legal age, Filipino, single and a resident

of Green meadows Subd., Brgy. Sto. Niño, Tugbok District, Davao City,
jjjjj) That I am an Educational Plan Scholar/beneficiary;
kkkkk) That as such, I was issued Educational Plan Policy;
lllll) That unfortunately, the said policy was misplaced in my

house and diligent efforts to locate the lost document proved
to no avail;
mmmmm) That I am executing this affidavit to attest the truth

the Government Service Insurance System (GSIS) for
whatever purpose this may serve in connection with my
educational plan claim.

MARIA ANNY G. YANONG
Affiant
SUBSCRIBED AND SWORN to before me this 18tH day of February, 2013,

________________________________________

x--------------------------/
Affidavit Of Loss
I, ALEX BUSTAMANTE TE ENG FO, of legal age, Filipino, married and a

resident of No. 131 Mutya St., Doña Paz Subd., Sasa, Davao City, Philippines,
and say:
nnnnn) That I am an owner of a duly license firearm, the

particulars of which are as follows:
12 Gauge MOSBERGE Shotgun

with Serial No. MV89933E
ooooo) That on or about November 3, 2012, my said

firearm was missing in my place of residence;
ppppp) That diligent efforts to locate the lost gun proved to

no avail;
qqqqq) That I am executing this affidavit to attest the truth
Police Station 4, Sasa, Davao City for purposes of recording.

ALEX B. TE ENG FO
Affiant
SUBSCRIBED AND SWORN to before me this 5st day of February, 2013,

________________________________________

x--------------------------/
Affidavit
I, TIMOTEO LISTON, Sr., 94 years old, Filipino, widower and a resident
of 875 Quezon Boulevard, Davao City, Philippines, after having been duly
rrrrr) I am the eldest of the six children of CIRILO LISTON and

EUGENIA TUROLLO who was born on January 16, 1919 in
Camotes, Cebu.
sssss) I was married to PORFERIA GUIAO of Davao City.

She was born on September 10, 1927;
ttttt) With our marital union, we were blessed with eleven (11)
children:
Name of Child Date of Birth Place of

Birth
1) Leonora Liston Torre _Sept. 27. 1949 _ _Davao City___
2) Gaudiosa Liston Agujetas _Mar. 7, 1950___ _Davao
City___
3) Leonida Liston Amigable_Oct. 6, 1952___ _Davao City___
4) Ramon Giuao Liston _Nov. 15, 1955_ _Davao
City___
5) Corazon Liston Enemenzo _Nov. 13, 1956_ _Davao
City___
6) Danilo Guiao Liston _Mar. 2, 1959__ _Davao
City___
7) Nerio Guiao Liston _Oct. 14, 1962_ _Davao
City___
8) Angelita Liston Bestodio _Apr. 22, 1964_ _Davao City___
9) Manuel Guiao Liston _July 4, 1965__ _Davao City___
10) Rogelio Guiao Liston _Mar 13, 1967__ _Davao City___
11) Timoteo Guiao Liston, Jr. _Apr. 6, 1969___ _Davao City___
uuuuu) My sixth child, DANILO GUIAO LISTON, was married

to CARMENCITA CAINDOC CALIAO. Their marriage was
solemnized on October 28, 1987 at the Sta. Ana Parish;
vvvvv) With their marital union, they were blessed with

two (2) children, namely:
1) DINA FE CALIAO LISTON March 5, 1988 Davao City

2) Danica Claire Caliao Liston February 6, 2001 Davao City
wwwww) I am executing this affidavit to attest the truth of

the foregoing facts for whatever purpose this may serve.

__________________, in the City of Davao, Philippines.
TIMOTEO LISTON
Affiant

Doc. No. __________

Page No. __________
Book No. __________
Series of 2013.

x--------------------------/
Affidavit Of Loss
I, AILEEN A. QUIÑONES, of legal age, Filipino, single and a resident of

Binugao, Sta. Marina, Toril, Davao City, Philippines, after having been duly
xxxxx) That I am a holder of the following documents:

a) Diploma from Holy Cross of Davao College;
b) Transcript Of Records;
c) NSO Birth Certificate;
d) Police Clearance;
e) Cedula;
f) SSS EI & E2;
g) Philhealth ID;
h) Alumni ID;
i) BIR ID; and
j) Nokia 5233 cellular phone;
yyyyy) That at about 9:00 in the morning of January 29,

2013, while at Central Warehouse, Lanang, my envelope
containing the above-mentioned documents was stolen;
zzzzz) The efforts to locate the lost documents proved to

no avail;
aaaaaa) That I am executing this affidavit to attest the truth

the office concerned for whatever purpose this may serve.

AILEEN A. QUIÑONES
Affiant
SUBSCRIBED AND SWORN to before me this 1st day of February, 2013,

________________________________________

x--------------------------/
Affidavit Of Loss
I, HERMOSO VARGAS ESCOBIDO, of legal age, Filipino, widower and a
resident of 99 JP Cabaguio Ave., Ballener Compound, Paciano Bangoy, Agdao,
bbbbbb) That I am a holder of Identification Cards for being

a Senior Citizen;
cccccc) That at about 11:00 in the morning of January 22,

2013, I discovered the loss of my wallet while on board a
public utility plying at the vicinity Sm City Mall;
dddddd) That my wallet contains money amounting to

P1,500.00 and the above-mentioned Identification Card;
eeeeee) That effort to locate the lost items proved to no

avail;
ffffff) That I am executing this affidavit to attest the truth of the

Office of the Senior Citizen (OSCA) to request for the
replacement of my lost Senior Citizen ID.

HERMOSO V. ESCOBIDO
Affiant
SUBSCRIBED AND SWORN to before me this 25 th day of January, 2013,

________________________________________

x--------------------------/
Affidavit Of Loss
I, HERMOSO VARGAS ESCOBIDO, of legal age, Filipino, widower and a

resident of 99 JP Cabaguio Ave., Ballener Compound, Paciano Bangoy, Agdao,
gggggg) That I am a holder of an Identification Cards for

being SSS member;
hhhhhh) That at about 11:00 in the morning of January 22,

2013, I discovered the loss of my wallet while on board a
public utility plying at the vicinity SM City Mall;
iiiiii) That my wallet contains money amounting to P1,500.00

and the above-mentioned Identification Cards;
jjjjjj) That effort to locate the lost items proved to no avail;
kkkkkk) That I am executing this affidavit to attest the truth

the Social Security System (SSS) to request for the
replacement of my lost SSS ID.

HERMOSO V. ESCOBIDO
Affiant
SUBSCRIBED AND SWORN to before me this 25 th day of January, 2013,

________________________________________

x--------------------------/
Affidavit
I, DANILO GUIAO LISTON, 54 years old, Filipino, married and a resident
of Samin-Samin St., Jerome, Agdao, Davao City, Philippines, after having
llllll) I am the sixth of the eleven children of TIMOTEO LISTON,

SR. and PORFERIA GUIAO who was born on March 2, 1959 in
Davao City.
mmmmmm) I was married to CARMENCITA CAINDOC

CALIAO. Our marriage was solemnized on October 28, 1987
at the Sta. Ana Parish of Davao City;
nnnnnn) Our marital union, blessed us with two (2) children,

namely:

oooooo) I am executing this affidavit to attest the truth of


DANILO G. LISTON
Affiant
SUBSCRIBED AND SWORN to before me this 24 th day of January 2013,

________________________________________
Doc. No. __________

Page No. __________
Book No. __________
Series of 2013.

x--------------------/
AFFIDAVIT OF UNDERTAKING
I, ZAINUDIN BAZAR KALAGIAN, of legal age, Filipino, married and a resident of km.
11Sasa, Davao City, Philippines, after having been duly sworn to in accordance with law, do hereby
depose and say that:
1. That I am the respondent in NPS DOCKET NO. XI-02-INQ-13-A-0163 for

Violation of Article 336 of the Revised Penal Code filed by MADELYN
VALENZUELA FALCASANTOS;
2. That with the help of my relatives, the complaint was amicably settled;
3. That I will refrain or will waive filing any complaint/counter-charge against

complainant or her relatives, particularly to ELBERT F. CASIPIT and
ROSEMARIE F. SECUYA;
4. That I am executing this affidavit with my own free will, attesting the truth of the
foregoing facts and to submit the same to the authorities concerned for
IN WITNESS HEREOF, I have hereunto affixed my signature this 23 rd day of January,

2013 at Davao City, Philippines.
ZAINUDIN BAZAR KALAGIAN

Affiant
SUBSCRIBED AND SWORN to before me this 23 rd day of January, 2013, in the City of
satisfied that he voluntarily executed and understood his affidavit.

x------------------------/
I, KESEREE HENSEL CRUZ NG, of legal age, Filipino, single and a resident of Sta. Avenue,
Davao City, Philippines, after having been sworn to in accordance with law do hereby depose and state that
11. I am a holder of Driver License No. L-02-06-013605;
12. at around 1:00 o’clock in the afternoon of January 17, 2013, while maneuvering my
SUBARU at our garage purposely to move out, my car accidentally hit a parked
vehicle just outside of our residence;
13. as a result thereof, the left side of the rear bumper of my vehicle incurred damage; and
4. That I am executing this affidavit to attest to the truth of the foregoing averments, for
insurance purposes.
IN WITNESS HEREOF, I have hereunto affixed my signature this 18 th day of January, 2016, in the
KESEREE HENSEL C. NG
Affiant
SUBSCRIBED AND SWORN TO before me this 19 th day of January, 2013, in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that she had
____________________________________
Doc. No. ________________

Page No. _______________
Book No. _______________
Series of 2013.
x------------------------/
Affidavit Of Identity
I, ENCARNACION ANCAJAS TUNDAG-OSOL, 58 years of age, Filipino, married and a

resident of Brgy. 22, Boulevard, Davao City, Philippines, under oath, depose and say:
5. That I was first married to AUSTIN P. OSOL. After seven (7) years, my said husband
died leaving me with two (2) children: Samuel Tundag Osol and Divina Tundag Osol;
6. That sometime in November 26, 19900, I re-married. I married ROMEO YERO

GADRINAB. Our marriage was celebrated at the St. Joseph Parish, Sasa, Davao
City;
7. That sometime in 1997, my second husband left for work abroad, particularly to the
Kingdom of Saudi Arabia. Since then, we have no communication with each other and
to date, his whereabout is not known;
8. That had been a member of the Social Security System (SSS) since 1978 with my
name ENCARNACION TUNDAG-OSOL registered as member/ensured. Later after
I remarried, I had my name changed and registered as ENCARNACION TUNDAG-
GADRINAB at the SSS;
9. That considering that my second husband, Romeo Yero Gadrinab, left me and, in fact,
had no more communication with him, I decided to amend my name at the SSS from
ENCARNACION T. GADRINAB to ENCARNACION TUNDAG OSOL/
ENCARNACION T. OSOL
10. That I am executing this affidavit to attest to the truth of the foregoing averments, with
my own free will and free from intimidation, purposely to submit the same to the Social
Security System (SSS) for the aforementioned purpose of changing my name back to
my previous registered name which is ENCARNACION T. OSOL.
IN WITNESS hereof, we have hereunto affixed our signatures this 16 th day of January, 2013, in the
ENCARNACION T. OSOL
Affiant
__________________________________

x------------------------/
I, WILLY VILLACENCIO Y JERENDA, of legal age, Filipino, married and a resident of Purok 20,
Calinan, Davao City, Philippines, under oath, depose and say:
11. That I am the biological father of JASMIN LAMOSAO VILLACENCIO who was born
on May 8, 1994 and is now eighteen (18) years of age;
12. That she is single and unemployed. She is still my dependent;
13. That recently, yesterday, January 15, 2013, she delivered a baby boy at the Robillo
Hospital of Calinan, Davao City. To date, she is still confined at the said hospital;
IN WITNESS hereof, we have hereunto affixed our signatures this 16 th day of January, 2013, in the
WILLY J. VILLACENCIO
Affiant
__________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
depose and state:
vv) That we personally know the person of MARIFE B. CELERIO-

MACATIOG;
ww) That she is the eldest of the four (4) children of spouses PIA A.
BIHAY and MARGARITO ESTEL L. CELERIO;
xx) That she was married to Freddie Boy A. Macatiog on October 30, 2004 in
Davao City. The nuptial rites was celebrated under the Worldwide Church
of God, Quezon Boulevard, Piapi, Davao City;
yy) Their marriage was registered, however, in their Marriage Contract the
given name of the father of Marife B. Celerio was registered as
MAGARITO only. It should have been MARGARITO ESTEL to conform
with his true, correct and complete name as shown in his father’s
personal documents, and among them is his Senior Citizen ID Card;
zz) That Margarito L. Celerio, father of Marife B. Celerio per Marriage

Contract of Freedie Boy A. Macatiog and Marife B. Celerio and
MARGARITO ESTEL, our neighbor, refer to one and the same person
whose true, correct and complete name is MARGARITO ESTEL
LAYOLA CELERIO;
aaa) That we both have personal knowledge of the facts above

because we been good neighbors with the family of Margarito Estel L.
Celerio for a long time;
bbb) That we are not related either by affinity or by consanguinity and

that we have no interest of whatsoever with the above-mentioned
persons;
ccc) That we are executing this affidavit to attest the truth of the
IN WITNESS HEREOF, we have hereunto affixed our signatures this 11 th day of

January 2013, in the City of Davao, Philippines.

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 11th day of January 2013, in the City of
________________________________

x--------------------------/
Affidavit
I, DANILO GUIAO LISTON, 54 years old, Filipino, married and a resident
of Samin-Samin St., Jerome, Agdao, Davao City, Philippines, after having
pppppp) I am the sixth of the eleven children of CIRILO

LISTON and EUGENIA TUROLLO who was born on March 2,
19___ in Davao City.
qqqqqq) I was married to CARMENCITA CAINDOC CALIAO.

Our marriage was solemnized on October 28, 1987 at the
Sta. Ana Parish officiated by Rev. Fr. __________;
rrrrrr) Our marital union, blessed us with two (2) children,

namely:

ssssss) I am executing this affidavit to attest the truth of


DANILO G. LISTON
Affiant
SUBSCRIBED AND SWORN to before me this 11 th day of January 2013,

________________________________________
Doc. No. __________

Page No. __________
Book No. __________
Series of 2013.

x--------------------------/
Affidavit of Mounting
Additional Accessory
I, JUVY B. CASTAÑEDA, of legal age, Filipino and a resident of Blk. 17,

Lot 26, ROSALINA III, Baliok, Davao City, Philippines, after having been duly
tttttt) I am an owner of a duly registered motor vehicle,

the particulars of which are as follows:
Make/Body Type Suzuki/Drop Side Pick-up

Engine Number K6A-6317360
Chassis Number DA62T-323631
Plate Number MDS 600
uuuuuu) I had mounted a canopy on the above-described

motor vehicle with one that I had legally purchase from Metal
Craft, Agdao, Davao City;
vvvvvv) I hereby certify that the said canopy is not a stolen

item and I hereby undertake to surrender the said vehicle or
will submit myself to an investigation should a conflict
regarding the same motor vehicle described above; and
wwwwww) I am executing this affidavit to attest the truth of

the foregoing facts, for purposes of registration.
JUVY B. CASTAÑEDA
Affiant
SUBSCRIBED AND SWORN to before me this 7th day of January 2013, in

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, VERONICA M. TOLENTINO and MIRALONA O. SOLOMON, both of legal age,

Filipino, married and residents of Phase 5, Blk. 94, Lot 13, Deca Homes, Tacunan, Tugbok
District and Purok 27, Happy Times Beach, Matina, Davao City, Philippines, respectively, after
a) That we personally know the person of RANNIE ALBINO LIBRADILLA;
b) That she is the fourth of the seven (7) children of spouses RAFAELA
CABALLERO ALBINO and BONIFACIO GLINOGO LIBRADILLA who
was born on June 11, 1989 in Nabunturan, COMVAL Province;
c) That her birth was registered. However, her GENDER record was
incorrectly reflected in her Certificate of Live Birth as MALE. It should
have been FEMALE to conform with her true and correct gender;
d) That Rannie Albino Libradilla whose gender is MALE per Certificate of

Live Birth and Rannie Albino Libradilla, our neighbor, refer to one and the
same person, referring to the above-mentioned person whose true and
correct gender is FEMALE;
e) That we both have personal knowledge of the facts above because we

been good neighbors friends with Rannie Albino for a long time;
f) That we are not related either by affinity or by consanguinity and that we

g) That we are executing this affidavit to attest the truth of the foregoing
averments.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 7 th day of January,
VERONICA M. TOLENTINO MIRALONA O. SOLOMON

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 7 th day of January, 2013, in the City of
________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, VERONICA M. TOLENTINO and RANNIE ALBINO LIBRADILLA, both of legal

age, Filipino, married and residents of Phase 5, Blk. 94, Lot 13, Deca Homes, Tacunan,
Tugbok District and Brgy. 22-C, Piapi Boulevard, Davao City, Philippines, respectively, after
ddd) That we personally know the person of MERALONA OMAN

SOLOMON;
eee) That she the same Meralona Rejenan Oman who is the third (3rd)
of the five (5) children of spouses MILA LANDA REJENAN and
ROSENDO CAMASORA OMAN, SR. who was born on July 7, 1983 in
Lampayan, Matalam, North Cotabato;
fff) That she was married to Demie Bangkailan Solomon in Kidapawan City
celebrated under the civil rites at the Mayor’s Office officiated by the Hon.
Mayor Rodolfo Y. Gatuangco on June 14, 2005;
ggg) That her date of birth was reflected at their Marriage Contract as
FEBRUARY 12, 1983. It should have been JULY 7, 1983 to
conform with her true and correct date of birth was registered in her
Certificate of Live Birth;
hhh) That Meralona Rejenan Oman, now Mrs. Meralona Oman

Solomon, whose date of birth is February 12, 1983 per Marriage Contract
and Meralona Rejenan Oman whose date of birth is July 7, 1983 per
Certificate of Live Birth, refer to one and the same person whose true and
correct date of birth per Certificate of Live Birth is JUNE 7, 1983;
iii) That we both have personal knowledge of the facts above because we
have been good neighbors/friends with Meralona Oman Solomon for a
long time;
jjj) That we are not related either by affinity or by consanguinity and that we
kkk) That we are executing this affidavit to attest the truth of the
IN WITNESS HEREOF, we have hereunto affixed our signatures this 7 th day of January,
VERONICA M. TOLENTINO RANNIE A. LIBRADILLA

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 7 th day of January, 2013, in the City of
________________________________

x--------------------------/
Affidavit
I, FLORENTINO JR. SUNGKIP Y SIMBAJON, of legal age, Filipino, single

and a resident of Blk. 17, Lot 14, Ruiz Village, Agdao, Davao City, Philippines,
and say that:
xxxxxx) on or about December 22, 2012, I learned from

Elaine Reantillo (my father’s second wife) that my father
(FLORENTINO, SR. C. SUNGKIP) who is working as chief
mechanic in an international mining company (HITACHI) was
in Baganga, Davao Oriental. They are living in Pampanga,
Luzon;
yyyyyy) on December 28, 2012, I tried to contact again my

father, but it was Elaine Reantillo who answered the phone
and informed me that my father was still in Baganga, Davao
Oriental;
zzzzzz) I asked Ms. Elaine when will my father leave the

country. She answered me that my father will be leaving
again for work in Luzaka, South Africa on January 15, 2013;
aaaaaaa) my father has been working broad since 1998;

bbbbbbb) I am executing this affidavit to attest the truth of
the foregoing facts.
IN WITNESS hereof, I have hereunto affixed my signature this 3 rd day of

FLORENTINO S. SUNGKIP, JR.

Affiant
SUBSCRIBED AND SWORN to before me this 3rd day of January 2013, in

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
depose and state:
lll) That we personally know the person of GALLY IPILI BAYBAYON;
mmm) That he is the youngest of the three (3) children of VIRGINIA SAN
JUAN IPILI with FAUSTO CONCON BAYBAYON;
nnn) That the birth of Gally was registered However, record at the Local
Civil Registrar of Davao City shows that his middle name was erroneously
registered as EPILI. It should have been IPILI to conform with the true
and correct maiden family name of her mother;
ooo) That Gally Epili Baybayon per Certificate of Live Birth (NSO
authenticated) and Gally Ipili Baybayon, our neighbor, refer to one and
the same person whose true and correct middle name is IPILI;
ppp) That we both have personal knowledge of the facts above
because we been good neighbors with Gally Ipili Baybayon for a long
time;
qqq) That we are not related either by affinity or by consanguinity and

persons;
rrr) That we are executing this affidavit to attest the truth of the foregoing
averments.
December, 2012, in the City of Davao, Philippines.

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 27th day of December, 2012, in the City
________________________________

x--------------------------/
Affidavit
I, JOAN SUECO LAYMA, of legal age, Filipino, single and a resident of

Purok 2, Rizal Extension, Brgy. 38-D, Davao City, Philippines, after having
ccccccc) That I was born on May 4, 1984 in Agusan del Sur;
ddddddd) That I am twenty eight (28) years old and on the

eight month of pregnancy. My live-in partner left me without
means of support;;
eeeeeee) That I am jobless and now a dependent of my

parents who are in Agusan del Sur;
fffffff) That I am executing this affidavit to attest the truth

the CHDC Hospital, Pichon St., Davao City, for whatever
purpose this may serve to my intent to avail delivery
package.

JOAN S. LAYMA
Affiant
SUBSCRIBED AND SWORN to before me this 21 st day of December,

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AGRIPINA CAUSING and PIO CUBILLAS, both of legal age, Filipino, married
and residents of Ma-a and Matina, Davao City, Philippines, after having been sworn to in
sss) That we personally know the person of JACINTO CAVIL

TIDALGO;
ttt) That he is the child of spouses Pablo Tidalgo and Jorgia Cavil who was
born on July 3, 1923 in Malitbog, Leyte;
uuu) That he is a World War II Veteran and is intending to claim

veteran’s benefit. However, when the documents for the pension
submitted to the Philippine Veterans Bank (Bank for brevity) was
accomplished, the name of the pensioner was reflected as JACINTO
CAVIL TIDALGO, SR. It should have been JACINTO CAVIL TIDALGO
only to conform with his name when he first enlisted at the Philippine
Army as Private First Class;
vvv) That Jacinto Cavil Tidalgo, Sr., veteran’s name submitted at the
Bank and Jacinto Cavil Tidalgo, a World War II veteran, refer to one and
the same person referring to the above-mentioned JACINTO CAVIL
TIDALGO, our friend who is a World War II veteran;
www) That we both have personal knowledge of the facts above

because we have been good neighbors with Jacinto Cavil Tidalgo;
xxx) That we are not related either by affinity or by consanguinity and

persons;
yyy) That we are executing this affidavit to attest the truth of the
AGRIPINA CAUSING PIO CUBILLAS

Affiant Affiant
________________________________

x--------------------------/
Affidavit Of Loss
I, FRANCISCO BRUA ANDRADE, of legal age, Filipino, married and a

resident of No. 1018 Washington St., Davao City, Philippines, after having
ggggggg) That at about 12 midnight of December 17, 2012, I

discovered the loss of my wallet upon arriving at my home
from work;
hhhhhhh) That my contain contained my Social Security

System ID and Driver License;
iiiiiii) That the lost wallet must have fallen on my way home or
have been pick-pocket and despite diligent efforts exerted to
locate, the same could not be found;
jjjjjjj) That the lost of my wallet containing my SSS ID and driver

license have been reported to Police Station 1, Sta. Ana,
Davao City; photocopy of the Record of Event is hereto
attached to form part hereof;
kkkkkkk) That the lost driver license was not confiscated nor
revoked in violation of traffic rules and ordinances;
lllllll) That I am executing this affidavit to attest the truth of the

Land Transportation Office, Davao City for whatever purpose
this may serve to my intent to request for replacement of my
lost driver license.

FRANCISCO B. ANDRADE
Affiant
SUBSCRIBED AND SWORN to before me this 17th day of December,

________________________________________

x--------------------------/
I, ELBERN MARK SAAGUNDO ALMOROTO, of legal age, Filipino, single
and a resident of No. 20 timbungan St., Jerome, Agdao, Davao City,
mmmmmmm) That I am an owner of a NARA SLA SET

valued at ONE HUNDRED THOUSAND PESOS
(Php=100,000.00);
nnnnnnn) That I have gain ownership of the said sala set thru
local purchase at local dealers in Davao City;
ooooooo) That I hereby guarantee the same appliance not to

be among the hot/stolen items, the same being legally
acquired and an absolute property of the undersigned affiant;
ppppppp) That I am executing this affidavit to attest the truth

of the foregoing averments and to submit the same to the
authorities concerned for loan purposes.

ELBERN MARK S. ALMOROTO

Affiant

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, JESSIE B. ROMERO and ROWENA C. SEDAZO, both of legal age, Filipino,
married and residents of Belen Homes, Bo. Pampanga, Davao City, Philippines, after having
zzz) That we personally know the person of ANTHONETTE

GUBATON MALCAMPO;
aaaa) That she is the eldest of the six (6) children of spouses Roger
Gonzalo Malcampo and Nina Galmiton Gubaton who was born on
June 13, 1992 in Sangay, Malita, Davao del Sur;
bbbb) That she is now a graduating student of Holy Cross College of

Sasa. However, her scholastic record shows that the name registered is
only ANTHONETTE GUBATON. It should have been ANTHONETTE
GUBATON MALCAMPO being a child of the spouses Roger Gonzalo
Malcampo and Nina Galmiton Gubaton;
cccc) That the reason for such discrepancy is that when she first
enrolled for her education, her parents were not yet married. As such, she
was registered with the maiden family name of her mother which is
GUBATON;
dddd) That Anthonette Gubaton per school record and Anthonette

Gubaton Malcampo per Certificate of Live Birth, refer to one and the
same person, referring to the above-mentioned ANTHONETTE
GUBATON MALCAMPO;
eeee) That we both have personal knowledge of the facts above

because we have known Anthonette for a long time;
ffff) That we are not related either by affinity or by consanguinity and

persons;
gggg) That we are executing this affidavit to attest the truth of the
JESSIE B. ROMERO ROWENA C. SEDAZO

Affiant Affiant
________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, AGRIPINA CAUSING and PIO CUBILLAS, both of legal age, Filipino, married
and residents of Ma-a and Matina, Davao City, Philippines, after having been sworn to in
hhhh) That we personally know the person of JACINTO CAVIL

TIDALGO;
iiii) That he is the child of spouses Pablo Tidalgo and Jorgia Cavil who was
born on July 3, 1923 in Malitbog, Leyte;
jjjj) That he is a World War II Veteran and is intending to claim veteran’s

benefit. However, when the documents for the pension submitted to the
Philippine Veterans Bank (Bank for brevity) was accomplished, the name
of the pensioner was reflected as JACINTO CAVIL TIDALGO, SR. It
should have been JACINTO CAVIL TIDALGO only to conform with his
name when he first enlisted at the Philippine Army as Private First Class;
kkkk) That Jacinto Cavil Tidalgo, Sr., veteran’s name submitted at the
Bank and Jacinto Cavil Tidalgo, a World War II veteran, refer to one and
the same person referring to the above-mentioned JACINTO CAVIL
TIDALGO, our friend who is a World War II veteran;
llll) That we both have personal knowledge of the facts above because we
have been good neighbors with Jacinto Cavil Tidalgo;
mmmm) That we are not related either by affinity or by consanguinity and

persons;
nnnn) That we are executing this affidavit to attest the truth of the
AGRIPINA CAUSING PIO CUBILLAS

Affiant Affiant
________________________________
Doc. No. ___________

Page No. ___________
Book No.___________
Series of 2012.

x--------------------------/
I, MARITES C. PEREZ, of legal age, Filipino, married and a resident of

Blk. 55, Lot 19 Parrot St., Cabantian Country Homes, Buhangin, Davao City,
qqqqqqq) That I am the owner of the following appliances:
PANASONIC Colored TV LA GERMANIA

Model No. TC – Model No. FS 521 00B
21GX10PS; Serial No. 1106 - - -
0798;
SHARP Washing Machine
Es – W605 SANYO Refrigerator
Model No. ES – W605 Model No. SR 290 NTW
Serial No. 80414694; Serial No. H2860061;
rrrrrrr) That I have gain ownership of the said household

appliance thru local purchase at local dealers in Davao City;
sssssss) That I hereby guarantee the same appliance not to

be among the hot/stolen items, the same being an absolute
property of the undersigned
ttttttt) That I am executing this affidavit to attest the truth

authorities concerned for loan purposes.

MARITES C. PEREZ
Affiant

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, VALERIANA MAG-ASO and BENILDA LANTERNA, both of legal age, Filipino,
married and residents of Monteverde/Gempesaw St., Brgy. 27-C, Davao City, Philippines, after
oooo) That we personally know the person of RICKY RAS DUA;
pppp) That he is the child of spouses ELPEDIO DUA and ANASTACIA

RAS who was born on May 9, 1968 in Davao City;
qqqq) That his birth was registered, however his family name and date of
birth were incorrectly registered in his birth record with the Local Civil
Registrar of Davao City, as follows:
DERA and May 9 1958, respectively. It should have been DUA for his
family name and MAY 9, 1968 for his date of birth;
FURTHERMORE, in the same birth record of Ricky Ras Dua, his father’s
family name is likewise incorrectly reflected as DERA. It should have
also been DUA to conform with his true and correct family name;
rrrr) That Ricky Ras Dera whose date of birth is May 9, 1958 per
Certificate of Live Birth and Ricky Ras Dua whose date of birth is May 9,
1968, our neighbor, refer to one and the same person whose true name
and correct date of birth is RICKY RAS DUA and May 9, 1968,
respectively;
ssss) That we both have personal knowledge of the facts above

because we have been good friends for a long time with Ricky Ras Dua;
tttt) That we are not related either by affinity or by consanguinity and

persons;
uuuu) That we are executing this affidavit to attest the truth of the

VALERIANA MAG-ASO BENILDA LANTERNA

Affiant Affiant
________________________________
x----------------------/
JOINT AFFIDAVIT
(Re: Delayed Registration Of Birth)
We, AMERICUS S. YANONG and CARMELITA L. NECOR, both of legal age,

Filipino, married and residents of Green Meadows subd., Brgy. Sto Niño, Tugbok District
and Agdao, Davao City, Philippines, after having been sworn to in accordance with law
do hereby depose and state:
vvvv) That we personally know the person of RODOLFO BAYRON

AÑASCO;
wwww) That he is the child of spouses MARGARITO CAPE AÑASCO

and CARMELITA SANCHEZ BAYRON;
xxxx) That he was born on June 17, 1959 in Bansalan, Davao del
Sur;
yyyy) That we both have personal knowledge of the facts above

because we have been good friends for a long time;
zzzz) That we are not related either by affinity or by consanguinity

and that we have no interest of whatsoever with the above-
mentioned person;
aaaaa) That we are executing this affidavit to attest the truth of the

AMERICUS S. YANONG CARMELITA L. NECOR

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 15 th day of October 2012, in the City
of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I
am satisfied that the affiants voluntarily executed and understood the foregoing
affidavit.
________________________________
x--------------------------/
I, MIEBIE MANUGORA PERMACIO, of legal age, Filipino, single and a

resident of Watusi St. corner Dumanlas Road, Davao City, Philippines, after
say:
uuuuuuu) That I am the an owner of SANIO REFRIGERATOR

with Serial No. 00200894, Model SR-8k;
vvvvvvv) That I have gain ownership of the said household

appliance thru my purchase of the same at SM City Mall,
Quimpo Blvd., Davao City;
wwwwwww) That I hereby guarantee the same appliance

not to be among the hot/stolen items, the same being an
absolute property of the undersigned
xxxxxxx) That I am executing this affidavit to attest the truth


MIEBIE M. PERMACIO
Affiant
SUBSCRIBED AND SWORN to before me this 19 th day of November,

________________________________________
x------------------------/
JOINT AFFIDAVIT
We, MARIBEL SALAS GECONCILLO and HYOSUNG LEE, 22 and 34 years of age,
Filipino and Korean National and residents of Rimas St., Cabaguio Avenue, Davao City,
Philippines, after having been sworn to in accordance with law do hereby depose and state:
1. That we are husband and wife having legally married to each other. Our
married was solemnized on March 3, 2010 under the civil rites
celebrated at the Municipal Trial Courts, Branch 1 of General Santos
City, solemnized by the Hon. Marie Ellengrid S.L. Baliguat;
2. That with our union, we were blessed with two children:
Name of Child Date Of Birth Place Of Birth

Won O Geconcillo Lee December 16, 2009 Koronadal, South Cotabato
Nine Geconcillo Lee December 29, 2010 General Santos City
3. That we are submitting herewith the following NSO authenticated documents,

in support of our petition for issuance of PERMANENT RESIDENT VISA for
HYOSUNG LEE, to wit:
bbbbb) Marriage Contract of Maribel S. Geconcillo and Hyosung Lee;

ccccc) Certificate of Live Birth of Won O Geconcillo Lee; and
ddddd) Certificate of Live Birth of Nine Geconcillo Lee;
averments, in compliance with the requirements for our request ofr
Permanent Resident Visa for Hyosun Lee.
MARIBEL S. GECONCILLO HYOSUNG LEE

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 19th day of November 2012, in the City
________________________________
x--------------------------/
I, MARIO G. CHIU, of legal age, Filipino, married and a resident of Davao

City, Davao City, Philippines, after having been duly sworn to in accordance
yyyyyyy) That I am the registered owner of a 100-square

meter residential lot situated at 131 Diamond St., SM Village,
Bangkal, Talomo, Davao City, the same being described in
Transfer Certificate of title No. T-109906 of the Registry of
Deeds for Davao City;
zzzzzzz) That a residential building is constructed in the said

property and a portion of it is being used by my daughter,
MARIA FE COSCA CHIU, as office of her medical supplies
operating under the name and style, MFCC PHARMA MEDICAL
SUPPLIES;
aaaaaaaa) That I am executing this affidavit to attest the truth


MARIO G. CHIU
Affiant
SUBSCRIBED AND SWORN to before me this 15 th day of November,

________________________________________
x--------------------------/
Affidavit Of Loss
I, JAY KARLOU P. SANCHEZ I, of legal age, Filipino, single and a resident

of Sto. Niño, Matina, Davao City, Philippines, after having been duly sworn to
bbbbbbbb) That I the registered owner of a KIA Delta motor

vehicle with Plate No. GRT 151;
cccccccc) That the Certificate of Registration of my said

vehicle was lost in my possession and despite diligent efforts
exerted, the same could not be found;
dddddddd) That the lost certificate was not confiscated nor

revoked in violation of the laws of the Philippine Republic;
eeeeeeee) That I am executing this affidavit to attest the truth

the Land Transportation Office, Davao City for whatever

_______________________________, in the City of Davao, Philippines.
JAY KARLOU P. SANCHEZ I

Affiant

________________________________________
x--------------------------/
Affidavit/Waiver
I, JEFFREY BARNACHEA Y GADIANA, of legal age, Filipino, single and a

resident of Catlea St., Phase 4, Ecoland, Matina, Davao City, Philippines, after
say:
ffffffff) That I am a professional driver;
gggggggg) That on or about August 26, 2012, at around 2:00

p.m., while driving a Maligaya Taxi cab with Plate No. LWN-
344 along Jobe St. Phase 2, Emily Homes, Cabantian,
Buhangin, this city, and upon reaching an intersection, a
Honda XRM motorcycle bearing Plate No. LI-9660 coming
from an alley bumped the left side front fender of my driven
taxi cab;
hhhhhhhh) That as a result thereof, my said driven taxi cab

incurred damages;
iiiiiiii)That the vehicular incident was amicably settled between

me and the driver of the motorcycle, WILLIAM CORTEZ
SANCHEZ;
jjjjjjjj)That I have no more claim of whatsoever with Mr. Sanchez

regarding the said vehicular incident;
kkkkkkkk) That I will refrain or waive pressing charges,

criminal or civil, against Mr. Sanchez;
llllllll)That I am executing this affidavit to attest the truth of the

Land Transportation Office, Davao City, for whatever purpose
this may serve to the release of the driver license of Mr.
William C. Sanchez.

JEFFREY G. BARNACHEA
Affiant
________________________________________

x--------------------------/
Affidavit Of Loss
I, HELVIE JANE LOPEZ Y MONSING, of legal age, Filipino, married and a

resident of No. 07 Lilac St., Blk. 5, Lot 5, El Rio, Bajada, Davao City,
mmmmmmmm) That I am high school graduate of school

year 2004-2005 of Mariano Peralta National High School of
Malita, Davao del Sur;
nnnnnnnn) That I enrolled for college at the Rizal Memorial

Colleges and during my enrollment, I submitted my FORM
137;
oooooooo) That however, my said FORM 137 could not be

found with my records at the school and despite efforts
exerted to locate, the same could not be found;
pppppppp) That I am executing this affidavit to attest the truth

the Registrar’s Office of Rizal Memorial Colleges to request
for copy of my grades (Transcript of Records).

HELVIE JANE M. LOPEZ

Affiant

________________________________________

x--------------------------/
Affidavit Of Loss
I, ERNESTO ARTAJO JUANILLO, JR., of legal age, Filipino, single and a

resident of 154-1 Quezon Blvd., Davao City, Philippines, after having been
qqqqqqqq) That I am have been employed as Security Guard of

Magno Security & Investigation Services (MASIS);
rrrrrrrr) That as such, I was issued Company Identification

Card bearing ID No. 367 (Company ID);
ssssssss) That I have resigned from my employment with

MASIS and I was required to surrender my said Company ID;
tttttttt) That however, my said Company ID as misplaced in

my place of residence and despite earnest efforts to locate,
the same could not be found;
uuuuuuuu) That my company ID was not confiscated in

violation of any law of the Philippine Republic;
vvvvvvvv) That I am executing this affidavit to attest the truth

MAIS for whatever purpose this may serve.

ERNESTO A. JUANILLO, JR.

Affiant
SUBSCRIBED AND SWORN to before me this 18th day of October, 2012, in

the affiant and that I am satisfied that the affiant had voluntarily executed
and understood the foregoing.
________________________________________

x--------------------------/
Affidavit Of Loss
I, REBECCA ATES Y ABAO, Of legal age, Filipino, married and a resident

of Samin-samin St., Jerome, Agdao, Davao City, Philippines, after having
wwwwwwww) That I am the mother of MARIANNE ABAO

ATES who is the registered owner of a Multi-Cab (for hire)
with License Plate No. 846;
xxxxxxxx) That my said daughter is out of the country and the

said vehicle was entrusted to me;
yyyyyyyy) That it is my intent to pay the monthly dues

(percentage) at the Bureau of Internal Revenue (BIR),
however, one of the requisite document is the Certificate of
Registration (CR) which I could not locate despite diligent
efforts exerted;
zzzzzzzz) That the CR was not confiscated nor revoked in

violation of Traffic Rules and Ordinances;
aaaaaaaaa)That I am executing this affidavit in behalf of my

daughter, attesting the truth of the foregoing averments
purposely to submit the same to the Bureau of Internal
Revenue, Davao City, for whatever purpose this may serve.

REBECCA A. ATES
Affiant
SUBSCRIBED AND SWORN to before me this 18th day of October, 2012, in

________________________________________

x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, YOLANDO C. ENATE and GILBERT S. HIPAYO, both of legal age, Filipino,
married and residents of km. 9 Sasa, Davao City, Philippines, after having been sworn to in
eeeee) That we personally know the person of JONATHAN CAGALITAN

SOSMEÑA;
fffff) That he is the child of spouses LUCRASIA CAGALITAN and

ARCADIO SOSMEÑA who was born on March 4, 1960 in Leyte;
ggggg) That he is a married person having entered into a Contract of

Marriage with Erlinda Daguil;
hhhhh) That in the Mrriage Contract, the given name of the mother of
Jonathan C. Sosmeña was registered as LOLITA. It should have been
LUCRESIA to conform with the true and correct given name of his mother
as shown in his Certificate of Live Birth;
iiiii) That Lolita Cagalitan, mother of Jonathan Cagalitan Sosmeña per

Marriage Contract and Lucresia Cagalitan, mother of Jonathan Cagalitan
Sosmeña per Certifcate of Live Birth refer to one and the same person
whose true and correct given/first name is LOLITA;
jjjjj) That furthermore, Jonathan’s middle name in his records of the

Social Security System, Commission on Election (per
Voter’s Certification) and with the Land Transportation
Office (his Driver License) were misspelled as CAGALETAN. It
should been CAGALITAN to conform with the true and correct family
name of Jonathan’s mother.
kkkkk) That we both have personal knowledge of the facts above

because we have been good friends for a long time with Jonathan C.
Sosmeña;
lllll) That we are not related either by affinity or by consanguinity and

persons;
mmmmm) That we are executing this affidavit to attest the truth of the
YOLANDO C. ENATE GILBERT S. HIPAYO

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 15th day of October 2012, in the City of
________________________________

City of Davao - - - - - - - - -) S.S.
x-----------------x
Affidavit For Change Of Name

With Explanation
I, ELIGIO MICULOB ADAPTAR, of legal age, Filipino, married and a resident of

Catmon, YCF Village, San Antonio, Agdao, Davao City, after having been sworn to in accordance
with law, depose and say that:
1.) I am a holder of a PROFESSIONAL DRIVER LICENSE with License No. LO2-86-025910 issued
by the Land Transportation, Davao City Agency;
2.) In my said license however, my given name registered is ELIZAR instead of my true given name
as appearing in my Certificate of Live Birth which is ELIGIO;
3.) The reason for the said discrepancy is that I have been using the name ELIZAR since childhood,
particularly in my elementary days up to the time when I was obliged to secure my Certificate of
Live Birth which unfortunately show that my true given name is ELIGIO;
4.) I HEREBY DECLARE under oath that ELIZAR MICULOB ADAPTAR per name registered as a
grantee/holder of Professional Driver License No. LO2-025910 and the undersigned ELIGIO
MICULOB ADAPTAR as could be gleaned in the authenticated Certificate of Live Birth, refer to
one and the same;
5.) I am executing this Affidavit to attest to the truth of the foregoing averments and to submit the
same to the Land Transportation Office, Davao City Agency, to request for the change of my
first/given name in my Professional Driver License from ELIZAR to ELIGIO; and
6.) That this request for change of name is not intended to conceal identity for the purpose of evading
violation of Traffic Rules and Ordinances and/or any other infractions against the law of the
Philippine Republic.
7.) FURTHER AFFIANT SAYETH NAUGTH.
IN WITNESS hereof, I have hereunto affixed my signature this 12 th day of October,

ELIGIO M. ADAPTAR
Affiant
SUBSCRIBED AND SWORN TO before me this 12th day of October, 2012, in the City of

City of Davao - - - - - - - - -) S.S.
x-----------------x
AFF I D AVI T
I, GREGG GEORGE PIEDAD GRUYAL, of legal age, Filipino, single and a resident of
No. 67 Garnet St., Santo Niño Village, Matina, Davao City, after having been sworn to in
accordance with law, depose and say that:
8.) I am a Bachelor of Science in Nursing graduate of University of Mindanao, for school year 2011-
2012;
9.) On August 19 to 21, 26 to 28 2010, I had rendered my Related Learning Experience (DUTY), under
Clinical Instructor Vincent Llamido, RN, at Southern Philippines Medical Center, particularly at the
Medical Surgical Ward;
10.)After completion of the required number of hours for DUTY, I was granted 89% grade;
11.)I am executing this Affidavit to attest to the truth of the foregoing averments and to submit the
same to the College of Nursing Dean’s Office of the University of Mindanao for the completion of my
Summary of Clinical Rotation.
12.)FURTHER AFFIANT SAYETH NAUGTH.
IN WITNESS hereof, I have hereunto affixed my signature this 9 th day of October, 2012,
in the City of Davao, Philippines.
GREGG GEORGE P. GRUYAL

Affiant
SUBSCRIBED AND SWORN TO before me this 9 th day of October, 2012, in the City of
City of Davao - - - - - - - - -) S.S.
x-----------------x
AFFIDAVIT OF ADVERSE CLAIM
I, RODEL LIVA LARA, of legal age, Filipino, married and a resident of Block 2 Lot 13, San
Lorenzo Village Phase 2 Puan, Davao City, after having been sworn to in accordance with law, depose
and say that:
13.)I am the VENDEE of a lot as evidenced by Acknowledgement Receipt of Full Payment issued to
me by Evangeline Saron Concepcion, the VENDOR;
14.)The Acknowledgement Receipt of Full Payment (Attached herewith as Annex “A”) was executed by
VENDOR Evangeline Saron Concepcion in my favor on November 13, 2009. The lot sold in
my favor consists of Two Hundred (200) square meters is part of a parcel of land covered by
Transfer Certificate of Title No. T-436961. As such the VENDOR Evangeline Saron
Concepcion has since then relinquished all her rights, interests and participation over the aforesaid lot
in my favor, the VENDEE.
15.)However, it has come to my knowledge that the parcel of land covered by Transfer Certificate of
Title No. T-436961 which includes my one (1) lot was mortgaged by VENDOR Evangeline Saron
Concepcion to a certain Albert D. Vasquez for Five Hundred Thousand Pesos (PHP 500,000.00) on
March 5, 2012, WITHOUT MY KNOWLEDGE AND CONSENT as evidenced by its annotation in
the said title. (a CERTIFIED COPY of which is hereby attached as Annex “C”);
16.)My ownership to the said lot precedes that of the date of the mortgage. Hence, when it was mortgage,
the VENDOR did not have the authority for as early as November of 2009 I was and still is the legal and
lawful owner of the said lots.
17.)Unless an adverse claim is annotated on the aforesaid Transfer Certificate of Title, I, who is the legal
owner of the said lots is in danger of being defrauded and deprived of my just and valid right over the
aforesaid parcel of land.
18.) As such, I am executing this Affidavit in support of my request for the annotation
of an adverse claim over the parcel of land described herein.
IN WITNESS hereof, I have hereunto affixed my signature this 5 th day of October, 2012, in
RODEL LIVA LARA
Affiant
SUBSCRIBED AND SWORN TO before me this 5th day of October, 2012, in the City of
satisfied that she voluntarily executed and understood the foregoing affidavit.

x--------------------------/
Affidavit Of Loss
I, JUSTIN GERALD H. GONZALES, a minor and a resident of Nova Tierra,

Lanang, Davao City, Philippines, after having been duly sworn to in
bbbbbbbbb) That I am 2nd year high school student of

Philippine Science High School, Mintal, Davao City;
ccccccccc) That as such I was issued School ID. However, my

said ID was misplaced/lost in my possession and despite
efforts exerted to locate, the same could not be found;
ddddddddd) That I am executing this affidavit to attest to

the truth of the foregoing averments and to submit the same
to the Philippine Science High School to request for a
replacement of my lost School ID.

JUSTIN GERALD H. GONZALES

Affiant
SUBSCRIBED AND SWORN to before me this 1st day of October, 2012, in

________________________________________

x--------------------/
Affidavit of Waiver
I, JAN-ERIK E. DAHLGREN, of legal age, Swedish national, married and a resident of

Carmelo Homes, Puan, Davao City, after having been duly sworn to in accordance with law, do
2. That I am the husband of GEMMA LAGUE DAHLGREN, a Filipino citizen, who

purchased a parcel of land from ARNOLD E. NAJERA which property is covered by Transfer
Certificate of Title No. T-254792 of the Registry of Deeds for Davao City, Philippines, situated
in the Barrio of Puan, Davao City, and containing an area of One Hundred Fifty (150) Square
Meters, more or less, the sale being evidenced by Deed of Absolute Sale dated
__________________, 2004 denominated as Doc. No. _____; Book No. _________; Page
No. ____________; Seires of 2004 of the notarial registered of Atty. ________________;
3. That the money used in the purchase of the aforementioned parcel of land
exclusively comes from her paraphernal funds and I have not contributed any
to the purchase of the same;
4. That I hereby WAIVE my right, share, participation and interest iin the
aforesaid parcel of land in favor of my wife;
5. That I hereby declare that said property exclusively belongs to my wife,

Gemma Lague Dahlgren;

averments, for whatever legal purpose this may serve and for purposes not
contrary to law.
IN WITNESS WHEREOF, we have hereunto set our hands this ___________________,

July 2004 at the City of Davao, Philippines.
JAN-ERIK E. DAHLGREN
Affiant
SUBSCRIBED AND SWORN to before me this ________________________, in the
City of Davao, Philippines and I further certify that I have personally examined the affiant and I
am satisfied that he had voluntarily executed and understood their affidavit.

x------------------------/
Affidavit/Waiver
We, _______________ and __________________, of legal age, Filipino, single and residents of
________________, Davao City, Philippines, after having been sworn to in accordance with law do hereby
depose and state:
15. That we are the three (3) of the four (4) surviving children of the late GUSTIN AGUJAR
and MERCEDES DOLORITOS who died sometime in January 4, 2001 and November
1997;
16. That during their marital union, the parents have acquired a property, house & lot, at
St. Mary St., Jerome, Agdao, Davao City;
17. That an electrical facility was installed on the said property and the registered name is
that of my father;
18. That our brother, REDEMTOR DOLORITOS AGUJAR, is now residing on the house
left by our father and has no other place to dwell;
19. That as such, we hereby waived our respective rights and interest over the said facility
to our said brother, and hereby grant our consent for him to have the registered
consumer of the DLPC Account for the said facility transferred to his name;
20. That we are executing this affidavit with our own free will, attesting to the truth of the
foregoing facts and to submit the same to the Davao Light Power * Company for the
aforementioned purpose; and
21. That we are setting the DLPC free and faultless and will hold ourselves solely liable
should a conflict arise in the transfer of registered consumer from that of our father to
our brother, Redemtor D. Agujar.
IN WITNESS hereof, we have hereunto affixed our signatures this _____ th day of
Affiant Affiant
Affiant
SUBSCRIBED AND SWORN TO before me this _____ th day of ___________, in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that the
affiants have voluntarily executed and understood the foregoing affidavit..

City of Davao - - - - - - - - -) S.S.
x-----------------x
I, JASMICRISTY VALLESCAS RECLA, of legal age, Filipino, married and a resident of

83 Ulas, Davao City, after having been sworn to in accordance with law, depose and say that:
20.)I am the VENDEE of two (2) lots as evidenced by two (2) Deeds of Sale entered into by me and
Evangeline Saron Concepcion, the VENDOR;
21.)The first Deed of Sale (Attached herewith as Annex “A”) was executed by VENDOR Evangeline
Saron Concepcion in my favor on May 9, 2009. The lot sold in my favor consists of One
Hundred Sixty Two (162) square meters is part of a parcel of land covered by Transfer
Certificate of Title No. T-436961. The technical description of the said lot is expressly stated in the
said Deed of Sale.
22.)The second Deed of Sale (Attached herewith as Annex “B”) was executed by VENDOR Evangeline
Saron Concepcion in my favor on September 9, 2012. However, as early as September 26,
2010, the purchase price of the said lot was already fully paid by me, the VENDEE. The lot sold in my
favor consists of Two Hundred Seventy Three (273) square meters is part of a parcel of land
covered by Transfer Certificate of Title No. T-436961. The technical description of the said lot is
expressly stated in the said Deed of Sale.
23.)As such the VENDOR Evangeline Saron Concepcion has since then relinquished all her rights,
interests and participation over the aforesaid lots in my favor, the VENDEE.
24.)However, it has come to my knowledge that the parcel of land covered by Transfer Certificate of
Title No. T-436961 which includes my two (2) lots, was mortgaged by VENDOR Evangeline
Saron Concepcion to a certain Albert D. Vasquez for Five Hundred Thousand Pesos (PHP
500,000.00) on March 5, 2012, WITHOUT MY KNOWLEDGE AND CONSENT as evidenced by its
annotation in the said title. (a CERTIFIED COPY of which is hereby attached as Annex “C”);
25.)My ownership to the said lots precedes that of the date of the mortgage. Hence, when it was mortgage,
the VENDOR did not have the authority for as early as September of 2010, I was and still is the legal
and lawful owner of the said lots.
26.)Unless an adverse claim is annotated on the aforesaid Transfer Certificate of Title, I, who is the legal
owner of the said lots is in danger of being defrauded and deprived of my just and valid right over the
aforesaid parcel of land.
27.) As such, I am executing this Affidavit in support of my request for the annotation
of an adverse claim over the parcel of land described herein.
IN WITNESS hereof, I have hereunto affixed my signature this 13 th day of September, 2012,
JASMICRISTY VALLESCAS RECLA

Affiant
SUBSCRIBED AND SWORN TO before me this 13th day of September, 2012, in the City of
satisfied that she voluntarily executed and understood the foregoing affidavit.

x------------------------/
Joint Affidavit
(Cohabitation)
We, RAFAEL VILLON DAGOT and JENNIBELLE MAGAWAY ACEDERA, 64 and 33
years old, Filipino, widow and widower and residents of Camarin St., New Lizada, Toril, Davao
43. we have been living together as husband and wife without the benefit of
marriage for more than five (5) years, since May 2007, to date;

consanguinity
3. there is no legal impediment between us to marry each other;
4. That we are executing this affidavit with our own free act and to submit the
same to the authorities concerned for whatever purpose this may serve to our
intent to marry each other in accordance with Article 34 of the New Civil Code
of the Philippines.
RAFAEL V. DAGOT JENNIBELLE M. ACEDERA

Affiant Affiant
Corroboration
We, LEAH K. MAPAYO and MARILE A. TARE, both of legal age, Filipino,
single/married and residents of Matina and Toril, Davao City, Philippines, respectively, after
1. That the statements above made by the affiant are true and correct to the best
of our knowledge, information and belief;
2. That we both have personal knowledge of the facts above because we have
been good friends for a long time;
facts.
LEAH K. MAPAYO MARILE A. TARE

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 6 th day of September, 2012, in the City

x------------------------/
Joint Affidavit
(Change Color And Body/)
We, ELIZABETH D. CUIZON and ALLAN D. CUIZON, both of legal age, Filipino, widow/single
(mother & son) and residents of Bohol Ave., Toril, Davao City, Philippines, respectively, after having been
sworn to in accordance with law do hereby depose and state:
1. That by virtue of an instrument, Extra Judicial Settlement With Waiver of Rights

executed by my family over a motorcycle described below, I, ELIZABETH D.
CUIZON, am now the owner of the said motorcycle, particularly described as follows:
MAKE/TYPE HONDA WAIVE 100 MC W/SIDECAR

MOTOR NO. HC08E-6029220
SERIAL/CHASSIS NO. KRS11-04X-029220
FUEL GAS
COLOR BLUE
PLATE NO. YF-5908
2. That I intend to change the color and the body of the side car (‘payong-payong’) of
my said motorcycle w/sidecar from its original BLACK to YELLOW, and body type
“PAYONG-PAYONG” to CLOSE CAB;
3. That I, ALLAN D. CUIZON, personally caused the change of color and change of
body type of the above-described motorcycle of my mother;
4. That the job of painting and changing the type of body of the motorcycle has been
completed and the same is now roadworthy;
5. That we are executing this affidavit to attest to the truth of the foregoing averments
for purposes of registration and for whatever purpose this may serve to our intent to
apply for FRANCHISING; and
5. That we hereby undertake to surrender the same motorcycle described above and
submit ourselves for investigation should a conflict arise in the change of COLOR
and mounting of the close cab.
IN WITNESS HEREOF, we have hereunto affixed our signatures this ___________________, in

ELIZABETH D. CUIZON ALLAN D. CUIZON

Affiant/Owner Affiant/Painter/Mechanic
SUBSCRIBED AND SWORN TO before me this _______________, in the City of Davao,

Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that they
have voluntarily executed and understood the foregoing affidavit..

x------------------------/
I, ANGELINE NUÑEZ BURGOS, of legal age, Filipino, married and a resident of Roldan
Village, Ma-a, Davao City, Philippines, after having been sworn to in accordance with law do hereby depose
and state that
14. I am a holder of a Professional Driver License with DLR No. LO2-01-154878;
15. I am a registered owner of a motor vehicle, the particulars of which are as follows:
MAKE/TYPE TOYOTA FORTUNER SUV

MOTOR NO. 2KD5142972
SERIAL/CHASSIS NO. MR0ZR69G300102457
FUEL DIESEL
PLATE NO. LGV124
16. That at around 6:00 o’clock in the evening of July 16, 2011, while my said vehicle was
parked unattended at Bankerohan, Davao City, I noticed damages incurred on my
vehicle, to wit:
Scratches on the front bumper, Front Door,

Rear door, rear bumper and rear flare;
17. Upon inquiry, the incident was caused by the children playing around my vehicle; and
5. That I am executing this affidavit to attest to the truth of the foregoing averments, and for
insurance purposes.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 16 th day of August, 2012, in
ANGELINE N. BURGOS
Affiant
SUBSCRIBED AND SWORN TO before me this 16 th day of August, 2012 in the City of Davao,
____________________________________

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
Declaration Of Heirship
With Waiver
We, THE UNDERSIGNED HEIRS OF ALBERTO TERO ALMOROTO, of legal age, Filipino
and residents of Davao City, Philippines, after having been sworn to in accordance with law do hereby
depose and state:
1. That we are the only legitimate children/wife and surviving heirs of the late ALBERTO
TERO ALMOROTO who died intestate, without a will on July 28, 2012 in Davao City;
2. That during his lifetime, the deceased was a member of the Social Security System
(SSS);
3. That we, the legitimate children and legal heirs of the deceased do hereby waive and
relinguish our respective rights and interest over the SSS Pension unot and in favor of
our mother, CRESENCIA SAAGUNDO VDA. DE ALMOROTO;
4. That we are executing this affidavit to attest to the truth of the foregoing facts and to
apprise the authorities concerned, particularly the Social Security System (SSS) of the
same.
IN WITNESS WHEREOF, we have hereunto set our hands this 9 th day of August, 2012, at
Davao City, Philippines.
CRESENCIA S. ALMOROTO MARY JEAN A. ARANNGOSO

Affiant Affiant
JOCELYN A. ALINGIG NORBERT S. ALMOROTO

Affiant Affiant
ELVIE A. BALBUENA DENNIS S. ALMOROTO

Affiant Affiant
FLORAMIE S. ALMOROTO ELBERN MARK S. ALMOROTO

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 9 th day of August, 2012, in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiants and that I am satisfied that the
affiants voluntarily executed and understood the foregoing affidavit.
__________________________________

x------------------------/
Joint Affidavit
(Cohabitation)
We, REYNALD CALACAT DANGO and MATILDE PERIN MELLEJOR, both of legal age,
Filipino, single and residents of No. 832 Bolton Iceplant, Davao City, Philippines, respectively, after having
1. we have been living together as husband and wife without the benefit of marriage for
more than five (5) years, since 2004, to date;
2. I, REYNALD CALACAT DANGO, am thirty seven (37) years old having been born on
September 27, 1974 in Tagbilaran City and I, MATILDE PERIN MELLEJOR, 39
years old for having been born in March 14, 1973 in Davao City;
3. we are of majority age, single and have no legal impediment to marry each other;
4. That we are executing this affidavit with our own free act and to submit the same to
the authorities concerned for whatever purpose this may serve to our intent to marry
each other in accordance with Article 34 of the New Civil Code of the Philippines.
IN WITNESS hereof, we have hereunto affixed our signatures this 27 th day of July, 2012, in the
REYNALD C. DANGO MATILDE P. MELLEJOR

Affiant Affiant
CorroboratIon
We, ARLINDO D. PERIN and YOLANDO C. ENATE, both of legal age, Filipino, married and
residents of Ecoland and Doña Asuncion, Sasa, Davao City, Philippines, respectively, after having been
1. That the statements above made by the affiant are true and correct to the best of our
knowledge, information and belief;
5. That we are executing this affidavit to attest to the truth of the foregoing facts.
IN WITNESS hereof, we have hereunto affixed our signatures this 27 th day of July, 2012,
ARLINDO D. PERIN YOLANDO C. ENATE

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 27 th day of July, 2012, in the City of Davao,
_________________________________

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
Affidavit Of Consent
I, JULIET MICOMPAL BARRIGA, of legal age, Filipino, married and a resident of

Indangan, Buhangin District, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and say that:
4. That I am the parent of AL-VINCENT MICOMPAL BARRIGA;
5. That he was born on January 13, 1995 and is now seventeen (17) years of
age;
6. That he desires to work to earn a living;
7. That knowing my said son to be of sound mental and physical health and
finding his intention to work profitable for him, I am granting him my parental
consent;
8. That I am executing this affidavit with my own free will, attesting to the truth of
the foregoing averments and to apprise the authorities concerned of the
same.
IN WITNESS WHEREOF, I have hereunto set my hand this 7 th day of June, 2012 at the
JULIET M. BARRIGA
Affiant
_________________________________

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
I, MARIVIC PAROT PAPASIN, of legal age, Filipino, married and a resident of San
Lorenzo Village, Puan, Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and say that:
9. That I am the aunt of LIMUEL JAY ROAMAR PAROT;
10. That he is the child of spouses Edgar Javier Parot and Lilia Roamar Parot
who was born on September 10, 1994 in Zamboanga City;
11. That he is now seventeen (17) years of age, still a minor, but he is
desirous to work to earn a living;
12. That considering that he is of sound mental and physical health and
finding his intention to work profitable for him, I am granting him my consent
as a guardian;
13. That I am executing this affidavit with my own free will, attesting to the
truth of the foregoing averments and to apprise the authorities concerned of
the same.
IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of June, 2012 at the
MARIVIC P. PAPASIN
Affiant
_________________________________

x--------------------------/
Affidavit Of Loss
I, MARIA THERESA ROMERO BALLINGER, of legal age, Filipino, married

and a resident of Neem St., Green Meadows Subd., Brgy. Sto. Niño, Tugbok
District, Davao City, Philippines, after having been duly sworn to in
eeeeeeeee) That I am a holder of a Permanent Resident

Card (Green Card for brevity) from the United States of
America;
fffffffff) That on March 23, 2012, I traveled from the U. S. A.

to the Philippines;
ggggggggg) That upon arrival at Manila City, Philippines, I

discovered the loss of my Green Card;
hhhhhhhhh) That diligent efforts exerted to locate my lost

Green Card proved to no avail;
iiiiiiiii) That the lost card was not confiscated nor revoked
in violation of any law or rules and regulations;
jjjjjjjjj) That I am executing this affidavit to attest to the

truth of the foregoing averments and to submit the same to
the U. S. Department of Homeland Security, Embassy of the
United States of America for whatever purpose this may
serve to my intent to acquire transportation letter.
IN WITNESS hereof, I have hereunto affixed my signature this 30 th day of May,

MARIA THERESA R. BALLINGER

Affiant
SUBSCRIBED AND SWORN to before me this 30 th day of May, 2012, in

________________________________________

x--------------------/
Affidavit of No Landholding
I, DOMINADOR R. PACABIS, of legal age, Filipino, married to Conception G. Pacabis and now
residing at Relocation a resident of Ma-a, Davao City, Philippines, after having been duly sworn to in
5. That I am a part time laborer and to augment our income, my wife engage herself in a
small sari-sari store;
6. That I am renting a house for my family’s dwelling at Relocation, Barangay Sto. Niño,
Tugbok District, Davao City;
7. That I and my wife jointly have no landholding or any other property here in Davao
City, or anywhere in the Philippines;
8. That I am executing this affidavit to attest to the truth of foregoing facts and to submit
the same to the authorities concerned for whatever purpose this may serve to my
child’s educational scholarship requirement.
IN WITNESS WHEREOF, I have hereunto set my hand this 28 th day of May, 2012, at the City of
Davao, Philippines.
DOMINADOR R. PACABIS
Affiant
Philippines and I further certify that I have personally examined the affiant and I am satisfied that he
voluntarily executed and understood his affidavit.

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
I, CARMELITA LAMOSAO NECOR, of legal age, Filipino, widow and a resident of

Agdao, Davao City, Philippines, after having been duly sworn to in accordance with law, do
hereby depose and say that:
14. That I am the aunt of AMOR LAMOSAO;

15. That she is an illegitimate child of spouses Nestor Alasagas Angab and
Algen Bacolod Lamosao who was born on September 9, 2003 in Davao City;
16. That she has been under my guardianship since her father died and her
mother is nowhere to be found, since 2009;
averments and to submit the same to the authorities concerned for whatever
purpose this may serve to Amor Lamosao’s registration of birth.
IN WITNESS WHEREOF, I have hereunto set my hand this 25 th day of May, 2012 at the
CARMELITA L. NECOR
Affiant
SUBSCRIBED AND SWORN to before me this 25th day of May, 2012 in the City of
_________________________________

x------------------------/
I, ALFREDO DIONIO Y ANIEL, of legal age, Filipino, married and a resident of km. 9 Catalunan
Pequeño, Davao City, Philippines, under oath, depose and say:
22. That I am the father of ANGELINE JEAN NABATAR DIONIO who is 20 years of age;
23. That she is still single and unemployed. As such, she is my dependent being under my
financial support;
24. That she is eight (8) months pregnant, hence this affidavit;
IN WITNESS hereof, we have hereunto affixed our signatures this 22 nd day of May, 2012, in the
ALFREDO A. DIONIO
Affiant
SUBSCRIBED AND SWORN TO before me this 22 nd day of May, 2012, in the City of Davao,

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
With Waiver
I, JAZEL CARILLO Y CAÑADILLA, of legal age, Filipino, single and now temporarily residing at
Blk. 14, Lot 15, Phase 1, NHA Bangkal, Davao City, Philippines, after having been sworn to in accordance
with law do hereby depose and state:
5. That I am the only illegitimate child and surviving heir of the late Lolita Cañadilla
who died sometime on September 20, 2000;
6. That during her lifetime, my mother was an awardee of a National Housing Authority
(NHA) residential lot situated at Blk. 17, Lot 18, Phase 1, NHA Bangkal, Davao City;
7. That the said property has water facility connection under Account Number 16-
077627-6 with my mother’s name as consumer;
8. That since I am now the actual occupant and the one using and paying the water bills
of the said account, I hereby adjudicate unto myself the said property including the
facilities, particularly the water facility tapping;
9. That I am executing this affidavit to attest to the truth of the foregoing facts and to
submit the same to the Davao City Water District (DCWD) for whatever purpose this
affidavit may serve to my application for reconnection;
10. That furthermore I hereby request the DCWD that the consumer’s name be change
from that of my deceased mother to my name.
IN WITNESS WHEREOF, I have hereunto set my hand this 14 th day of May, 2012, at Davao
City, Philippines.
JAZEL C. CARILLO
Affiant
SUBSCRIBED AND SWORN TO before me this 14 th day of May, 2012, in the City of Davao,
have voluntarily executed and understood the foregoing affidavit.

x-----------------------/
AFFIDAVIT OF ADMISSION OF PATERNITY

WITH UNDERTAKING
I, RYAN DEVECAIS Y AYONGAO, of legal age, Filipino, single,

Philippine Army enlisted personnel with a rank of Private First Class (PFC)
detailed at 84th Bravo Coy stationed at Brgy. Tamayong, Calinan Dictrict,
Davao City and home address at No. 37 FTI Road, Zone 5, Purok 13, Signal
Village, Taguig City, Philippines, after having been duly sworn to in
5. That WINDY JANE PEFANIO CALIAO (Windy) is a Fifteen

(15)-year old minor having been born on august 23, 1996 in
Davao City;
6. That I and windy cohabited with each other, that is, we are
living together as husband and wife albeit without the benefit
of marriage;
7. That she is now five (5) months pregnant;
8. That I am the natural and biological father of the child that

she carrying;
9. That I hereby undertake to give financial support to Windy and

our common-child, including the expenses for her pre-natal
medication;
10. That I further undertake to marry her when she reaches the
legal age when the law permits her to marry;
7. That I am executing this affidavit in order to inform the

authorities concern on the truth of the foregoing facts and for
whatever legal purpose this may serve best.
IN WITNESS HEREOF, I have hereunto affixed my signature this 10th

day of May, 2012 at Davao City, Philippines.
RYAN A. DEVECAIS
Affiant
SUBSCRIBED AND SWORN to before me this 10th day of May, 2012,

in the City of Davao, Philippines and I further certify that I have personally
examined the affiant and I am satisfied that he voluntarily executed and
understood his affidavit.
____________________________________

x------------------------/
Joint Affidavit
(Cohabitation)
We, CHARITO M. YBAÑEZ and WILLIE D. GRANDE, both of legal age, Filipino, married and
residents of Sta. Teresita, Buhangin, Davao City, Philippines, respectively, after having been sworn to in
1. That personally know the persons of SHIELA MARTE JOROLAN DUGA and KING
ALLAIN GRANDE YBAÑEZ;
2. That they had been living together as husband and wife for more than five (5) years,
without the benefit of marriage;
3. That with their relationship, they were blessed with one (1) child, PRINCESS CARLY
NICOLE DUGA who was born on November 6, 2011 in Davao City;
3. That they are of majority age, single and have no legal impediment to marry each
other;
IN WITNESS hereof, we have hereunto affixed our signatures this ________________________,
CHARITO M. YBAÑEZ WILLIE D. GRANDE

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this ____________________________, at Davao

City , Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that
they have voluntarily executed and understood the foregoing affidavit.
Doc. No. ______________

Pge No. ______________
Book No. _____________
Series of 2012.

x------------------------/
Joint Affidavit
(Cohabitation)
We, SHIELA MARTE JOROLAN DUGA and KING ALLAIN GRANDE YBAÑEZ, 22 and 23 years
of age, respectively, Filipino, single and residents of Sta. Teresita, Buhangin, Davao City, Philippines,
1. That we have been living together as husband and wife without the benefit of marriage
for more than five (5) years, since 2006, to date;
3. That with our relationship, we were blessed with one (1) child, PRINCESS CARLY
NICOLE DUGA. She is now five (5) months old. Photocopy of her Birth Certificate is
hereto attached;
3. That we are of majority age, single and have no legal impediment to marry each other;
5. That we are executing this affidavit with out own free act and to submit the same to
IN WITNESS hereof, we have hereunto affixed our signatures this ________________________,

SHIELA MARTE J. DUGA KING ALLAIN G. YBAÑEZ

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this ____________________________, at Davao

City , Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that
they have voluntarily executed and understood the foregoing affidavit..
Doc. No. ______________

Pge No. ______________
Book No. _____________
Series of 2012.

x------------------------/
Affidavit/Support
I, CRISTILINO C. SABUCIDO, of legal age, Filipino, separated and a resident of Brgy. Sto. Niño,
Tugbok District, Davao City, Philippines, under oath, depose and say that:
26. Sometime in 2001, I cohabited with DUZYLLE L ECHAVEZ, that is, living together as
husband and wife without the benefit of marriage;
27. With our relationship, we were blessed with two (2) children, namely:
VANISSA ECHAVEZ SABUCIDO September 7, 2004 Davao City

MARY CRISEL ECHAVEZ SABUCIDO December 9, 2011 Davao City
and; that
28. I am executing this affidavit to attest to the truth of the foregoing averments and to
submit the same to the authorities concerned for whatever purpose this affidavit may
serve.
IN WITNESS hereof, we have hereunto affixed our signatures this ___ th day of ________________
CRISTILINO C. SABUCIDO
Affiant
SUBSCRIBED AND SWORN TO before me this ____ th day of ___________________, 2012, in the
City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied
that the affiant had voluntarily executed and understood the foregoing affidavit..

x------------------------/
I, ANJELLY C. COLE, of legal age, Filipino, married and a resident of

Calinan, Davao City, Philippines, hereby depose and say:
1. That I am a registered owner of a motorcycle, the particulars of which

are as follows:
MAKE/SERIES/TYPE HONDA ANF100MDP

ENGINE NO. KTL00E030948
CHASSIS NO. KTL00030998
PLATE NO. IW6774
2. That I had my motorcycle rented for PhP=100.00 per day by Peter dela
Cuz;
3. That however, said Peter dela Cruz was arrested for violation of
Republic Act 9165 and my motorcycle was confiscated and now part of
the exhibits in the above-entitled case and the same is now under the
custody of Police Station 10, Calinan, Davao City;
4. That she would like to take custody of the said motorcycle;
5. That she had caused the said motorcycle photographed and certified
by the Police Station Exhibit Custodian as accurately presenting the
same;

facts and to submit the same to the authorities concerned, for whatever
purpose this may serve to my intent to take custody of my motorcycle
mentioned above.
IN WITNESS hereof, I have hereunto affixed my signature this 13 th day of March,

ANJELLY C. COLE
Affiant
SUBSCRIBED AND SWORN TO before me this 13 th day of March, 2012, in the

and that I am satisfied that the affiant voluntarily executed and understood the foregoing
affidavit.
_________________________________

x--------------------------/
Affidavit Of Loss
I, FRANCE IONE PLAZA GAMAS, of legal age, Filipino, single and a
resident of door No. 4, Caparas Apt., Doña Luisa Ave., Doña Luisa Subd.
Phase 2, Ecoland, Matina, Davao City, Philippines, after having been duly
kkkkkkkkk) That I am a first year bonafide student of the

University of Mindanao;
lllllllll) That as such, I was issued a School Identification

Card (School ID);
mmmmmmmmm) That on or about February 29, 2012, I
lost my said school ID while at school campus at Matina;
nnnnnnnnn) That efforts exerted to locate the same

proved to no avail;
ooooooooo) That I am executing this affidavit to attest to

the truth of the foregoing averments and to submit the same
to the office of Registrar of the University of Mindanao,
Bolton, purposely to request for a replacement of my lost
school ID.

March, 2012, in the City of Davao, Philippines.
FRANCE IONE P. GAMAS

Affiant
SUBSCRIBED AND SWORN to before me this 6 th day of March, 2012, in

________________________________________

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
And Consent
I, MARILOU GARRIDO JOSIO, 38 years of age, Filipino, single and a resident of No. 26
Aster St., Phase IV-A, El Rio Vista, Bacaca, Philippines, after having been duly sworn to in
18. That I am the aunt of KENNETH DAVE JOSIO CABITING;
19. That he is the child of spouses Marissa Garrido Josio and __________
who was born on _________________ in ______________, Davao City;
20. That she has been under my guardianship after his mother was murder
by his father sometime in April 13, 2004;
purpose this may serve to the marriage of my niece with Dandy Albarico.
IN WITNESS WHEREOF, I have hereunto set my hand this _____ th day of ___________
MARILOU G. JOSIO
Affiant
SUBSCRIBED AND SWORN to before me this _____ th day of ___________, in the City
of Davao, Philippines and I further certify that I have personally examined the affiant and I am
satisfied that she voluntarily executed and understood his affidavit.

x-------------------/
Affidavit Of Adjudication
With Undertaking
I, JESS WINSTON AMISTAD IBARRETA, of legal age, Filipino, single and a resident
of Brgy. 76-A, Ilang-ilang St., Kabacan, Matian, Davao City, Philippines, after having been duly
9. That I am among the heirs of DEMETRIO BULFA IBARRETA, who, during

his lifetime is the registered consumer of a Davao Light & Power C. Inc.
(DLPC) electrical connection under Account No. 094-409203;
10. That my grandfather died without a will, and since I am now the one staying
at the said house where the electrical facility is connected and the one paying
the electrical bills, with the conformity of my co-heirs, I hereby adjudicate the
said electrical connection, and request for the transfer of the account to my
name;
11. That I hereby agree to indemnify and/or hold the DLPC, its officers and staff,
free and harmless from any suit, claim, expense, damage or liability, it or
they may incur/suffer through or in connection with my request for transfer
of the account of my grandfather to that of my name;
and to submit the same to the DLPC for my request of transfer of account
number to that of my name.
IN WITNESS WHEREOF, I have hereunto set my hand this 16 th day of January, 2012 at
JESS WINSTON A. IBARRETA

Affiant
SUBSCRIBED AND SWORN to before me this 16 th of January, 2012, in the City of Davao,
________________________________________
R. A. 9255 Form No. 1

(Devised May 2004)
x------------------ / Registry No. _____________
AFFIDAVIT TO USE THE SURNAME OF THE FATHER
I, ______RODULFO LAO MURILLO___, of legal age, Filipino, married and a resident of Balusong,
Matina, Davao City, Philippines, after having been duly sworn to in accordance with law, do hereby depose and say
that:
1. am seeking the change of surname in:
______ My Certificate of Live Birth __XXX_____ The Certificate of Live Birth of

____________ ROMMEL TOYONGAN CERVANTES______ who is my ________ SON_________;
2. She was born on ___ 21 October 1997 __ in ___________ DAVAO CTIY______________________
(date of birth) (Municipality/City)
____________________DAVAO________________________Philippines_______________________;
(Province) (Country)
3. The birth was recorded under Registry No. _____98-275______________ on __ January 25, 1998___;
4. The public document was registered under Registry No. __________________ on ________________;
5. The surname to be change is from ______ CERVANTES___________ to ______ MURILLO_________
pursuant to R. A. 9255;
6. I, the father, has sought the consent of my child as shown by her/his attached consent
(applicable only if the child is 18 yrs. Old and above);
7. In support hereof, I submit the attached private handwritten instrument including the following supporting
documents. (Use additional sheets if necessary)
a) __________________________________________________________________________________
b) __________________________________________________________________________________
8. I am filing this affidavit at the LCRO of _Davao City _ in accordance with R. A. 9255 and the implementing
rules and regulations;
9. I hereby certify that the statements made herein are true and correct to the best of my knowledge and
belief;
10. In truth whereof, I have hereunto affixed my signature this _10 th day of January, 2012_ at Davao City,
Philippines.
RODULFO LAO MURILLO

Affiant
SUBSCRIBED AND SWORN to before me this 10 th day of January, 2012, in the City of Davao,
Philippines and I further certify that I have personally examined the affiant and I am satisfied that he voluntarily
executed and understood his affidavit.
Republic of the Philippines

OFFICE OF THE CITY CIVIL REGISTRAR
City of Davao
Registered this _______ day of _______________________ after payment of

corresponding fee of _________________________ with O. R. No. __________________ and
entered in the Register of Legal Instrument (R. A. 9255) Page No. ___________ Book No.
_________, Reg. No. _____________________.

x-----------------------/ Registry No. _______________

I, ______RODULFO LAO MURILLO____, of legal age, Filipino, married and a resident of
Balusong, Matina, Davao City, Philippines, after having been duly sworn to in accordance with law, do
1. I am the natural and biological father of ROMMEL TOYONGAN CERVANTES who was
born on __21 October 1997 __ in __ DAVAO CTIY_________________;
2. My child was born out of wedlock and her mother is ELSIE TOYONGAN
CERVANTES;
3. That I am executing this affidavit in order to inform the authorities concern on the truth of
the foregoing facts and for whatever legal purpose this may serve best.
IN WITNESS HEREOF, I have hereunto affixed my signature this 10 th day of January, 2012 at
RODULFO LAO MURILLO

Affiant
____________________________________
R. A. 9255 Form No. 1

(Devised May 2004)
x------------------ / Registry No. _____________
I, ______RODULFO LAO MURILLO___, of legal age, Filipino, married and a resident of Balusong,
Matina, Davao City, Philippines, after having been duly sworn to in accordance with law, do hereby depose and say
that:

____________ BLISSIE TOYONGAN CERVANTES______ who is my ________daughter_________;
2. She was born on ___ 20 March 1996 __ at ______________ DAVAO CTIY_______________________
3. The birth was recorded under Registry No. _____96-18,495______________ on __ July 26, 1996____;
5. The surname to be change is from ______ CERVANTES___________ to ______ MURILLO_________
a) __________________________________________________________________________________
b) __________________________________________________________________________________
8. I am filing this affidavit at the LCRO of _Davao City _ in accordance with R. A. 9255 and the implementing
rules and regulations;
belief;
10. In truth whereof, I have hereunto affixed my signature this _10 th day of January, 2012_ at Davao City,
Philippines.
RODULFO LAO MURILLO

Affiant
Philippines and I further certify that I have personally examined the affiant and I am satisfied that he voluntarily
executed and understood his affidavit.

City of Davao

_________, Reg. No. _____________________.

x-----------------------/ Registry No. _______________
I, ______RODULFO LAO MURILLO____, of legal age, Filipino, married and a resident of

Balusong, Matina, Davao City, Philippines, after having been duly sworn to in accordance with law, do
1. I am the natural and biological father of BLISSIE TOYONGAN CERVANTES who was
born on __20 March 1996 __ in __ DAVAO CTIY_________________;
2. My child was born out of wedlock and her mother is ELSIE TOYONGAN
CERVANTES;
the foregoing facts and for whatever legal purpose this may serve best.
IN WITNESS HEREOF, I have hereunto affixed my signature this 10 th day of January, 2012 at
RODULFO LAO MURILLO

Affiant
____________________________________

x------------------------/
(Driver’s Affidavit)
I, JOHN SARAGOZA PEREYRAS, of legal age, Filipino, married and a resident of Lot 1B, Blk.
11, Park Avenue, Jereza Subd., Bajada, Davao City, Philippines, after having been sworn to in accordance
1. That I am the driver of the TOYOTA COROLLA 4-DOOR SEDAN with Plate No.
UKY461 when it figured vehicular accident at about 7:30 in the morning of December
14, 2011 at Agdao Public Market;
2. That the incident happened when I maneuvered the said vehicle to turn right at Lapu-
lapu St. going to R. Castillo St., and its rear right fender and rear door hit a parked
pushcart (Kariton);
3. That as a result of the incident my driven vehicle incurred damages: scratches and
dent on the rear right fender and rear right door;
4. That the above-described vehicle is owned and registered under the name of my
mother-in-law, MONICA R. GULINAO;
insurance purposes.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 23 rd day of December 2011, in
JOHN S. PEREYRAS
Affiant
SUBSCRIBED AND SWORN TO before me this 23 rd day of December, 2011 in the City of Davao,

x--------------------------/
Affidavit Of Loss
I, DICK QUIÑONES ANTERO, of legal age, Filipino, single and a

resident of Baganga, Davao Oriental, Philippines, under oath, depose and
say:
ppppppppp) That I am the teacher-adviser of Section
Jade, fourth year of class 1999-2000 of Crispin E. Rojas
National High School (former annex of Baganga National High
School) and one of my student was JOANNE E. BALANTE;
qqqqqqqqq) That she had completed the secondary

education and as such, she was awarded diploma;
rrrrrrrrr) That she was married to a Japanese National and

was able to travel to Japan;
sssssssss) That for her travel abroad, she was required to

submit documents and among them is her HIGH SCHOOL
DIPLOMA;
ttttttttt) That she intends to come back home to the

Philippines, however her Philippine Travel Passport was lost in
her possession;
uuuuuuuuu) That to apply at the Philippine Embassy in

Japan to possess a new passport. However, she was again
required to submit documents, including her DIPLOMA which
she had already submitted at the Japanese Consulate in
Manila, and efforts to retrieve her documents proved to no
avail, hence, this affidavit;
vvvvvvvvv) That I am executing this affidavit in behalf of my

student JOANNE E. BALANTE, attesting to the truth of the

December, 2011 in the City of Davao, Philippines.
DICK Q. ANTERO
Affiant
SUBSCRIBED AND SWORN to before me this 14th day of December, 2011,

________________________________________

x------------------------/
Joint Affidavit
(Change Color/Undertaking)
We, RODEL ANCHETA and A _____________, both of legal age, Filipino, single/married and
residents of _______________ and __________, Davao City, Philippines, respectively, after having been
1. That I, RODEL ANCHETA, am the new owner of a motor vehicle, the particulars of
which are as follows:
MAKE/TYPE NISSAN Califoria SUZUKI PICK-UP W/

CANOPY
MOTOR NO. 5117490
SERIAL/CHASSIS NO. DA51T-137435
FUEL GAS
COLOR WHITE
PLATE NO. MCE-143
2. That I intend to change the color of my said motor vehicle from the original WHITE to
AQUA BLUE, and as such, I contracted Mr. Arnel C. Tobias to do the job;
3. That I, ___________, a automobile painter by profession, was contracted and have

caused the change of color of the above-described vehicle for its original color to
AQUA BLUE;
4. That we are executing this affidavit to attest to the truth of the foregoing averments for
purposes of registration at the Land Transportation Office (LTO), Davao City, of the
change of color of the above-described motor vehicle; and
5. That we hereby undertake to surrender the same motor vehicle described above and
submit ourselves for investigation should a conflict arise in the change of COLOR of
the said vehicle.
IN WITNESS HEREOF, we have hereunto affixed our signatures this ___________, in the City of
Davao, Philippines.
________________________ ___________________________
Affiant/Owner Affiant/Auto Painter


x------------------------/
JOINT AFFIDAVIT
(Discrepancy)
We, JUDITH STA. ANA and JENNIFER FLORES, both of legal age, Filipino, married
and residents of Toril, Davao City, Philippines, after having been sworn to in accordance with
nnnnn) That we personally know the child KEITH DUSTIN BLAO
PARIDO, whose parents is REYMUS PARIDO and NORHANA G. BLAO.
The child Keith Dustin was born on January 2, 2011 at St. Elizabeth
Hospital, Inc., General Santos City;
ooooo) That the birth of the child was registered. He was registered as
KEITH DUSTIN BLAO PARIDO. However, in baptism, the name
registered was KEITH DUSTIN RICHARDS. It was his grandmother who
registered the child during baptism.
Likewise, the name of the parents in the Baptismal Certificate were

incorrectly registered as REYMUS RICHARDS and RHOANNA BLOA. They
should have been registered as REYMUS PARIDO and NORHANA G. BLAO
to conform with the true and correct names of the parents of Keith Dustin;
ppppp) That Keith Dustin Blao Parido per Certificate of Live Birth and
Keith Dustin Richards per Certificate of Baptism refer to one and the
same child, referring to the above-mentioned child, Keith Dustin Balo
Parido;
qqqqq) That we both have personal knowledge of the facts above

because we have been good friends for a long time;
rrrrr) That we are not related either by affinity or by consanguinity and

persons;
sssss) That we are executing this affidavit to attest the truth of the
IN WITNESS HEREOF, we have hereunto affixed our signatures this 2nd day of
JUDITH STA. ANA JENNIFER FLORES

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 2nd day of December, 2011, in the City
________________________________
Doc. No. _______________

Page No. _______________
Book No. _______________
Series of 2011.

x------------------------/
We, REYMUS PARIDO and NORHANA GUIANDAL BLAO, both of legal age,
Filipino, single and residents of Blk. 12, Lot 19, Isabella Homes, General Santos City,
Philippines, after having been sworn to in accordance with law do hereby depose and
state:
ttttt) That we are unmarried couple and out of our relationship, we

were blessed with one child: KEITH DUSTIN BLAO PARIDO, who
was born on January 2, 2011 at St. Elizabeth Hospital, Inc.,
General Santos City;
uuuuu) That our child is now eleven (11) months old and his
grandmother, EMILY PARIDO RICHARDS, would like to travel
abroad to Australia with Keith Dustin;
vvvvv) That knowing that our mother, Mrs. Richards, would and
could take good care of our child while in Australia, we are granting
our parental consent for his travel abroad;
wwwww) That further, we are giving our consent for our child to
possess Philippine Travel Passport;
xxxxx) That we are executing this affidavit to attest the truth of the
concerned for whatever purpose this may serve for our child to
possess Philippine Passport and to his intended travel with his
grandmother to Autralia.
IN WITNESS HEREOF, we have hereunto affixed our signatures this 2 nd day of

REYMUS PARIDO NORHANA G. BLAO

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 2nd day of December, 2011, in

and that I am satisfied that the affiants voluntarily executed and understood the
________________________________
Doc. No. _______________

Page No. _______________
Book No. _______________
Series of 2011.

x------------------------/
Joint Affidavit
(Cohabitation)
We, ARMANDO LEYSON FENEQUITO and JUDITH BARLIZO MIGUEL, 59 and 44 years of
age, Filipino, single and residents of Blk. 80, Lot 12, Rosalina lll, Baliok, Talomo District, Davao City,
Philippines, respectively, after having been sworn to in accordance with law do hereby depose and state:
3. That with our relationship, we were blessed with two (2) children:
ARJO April 16, 2000 General Santos City

AIZABELLE December 2, 2001 Digos City
IN WITNESS hereof, we have hereunto affixed our signatures this 26 th day of July, 2011, in the
ARMANDO L. FENEQUITO JUDITH B. MIGUEL

Affiant Affiant
CorroboratIon
We, FREDIELINDA G. LARIOSA and AMERICUS S. YANONG, both of legal age, Filipino,
married and residents of Blk. 78, Lot 12, Baliok, Talomo District and Green Meadows Subd., Brgy. Sto.
Niño, Tugbok District, Davao City, Philippines, respectively, after having been sworn to in accordance with
1. That the statements above made by the affiants are true and correct to the best of our
IN WITNESS hereof, we have hereunto affixed our signatures this 26 th day of Jly, 2011, in the City
FREDIELINDA G. LARIOSA AMERICUS S. YANONG

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 26 th day of July, 2011, in the City of Davao,
voluntarily executed and understood the foregoing affidavit..

x--------------------------/
Affidavit/Waiver
I, JAVIER EGUIA BAYNO, of legal age, Filipino, married and a resident

of Samantha Homes, Catalunan Pequeño, Davao City, Philippines, under
oath, depose and say that:
wwwwwwwww) I am one of the three (3) children of Aquilina

E. Bayno, widow, who died sometime June 2, 1999;
xxxxxxxxx) During her lifetime, she executed a Last Will and

Testament which she submitted at the National Housing
Authority (NHA), stating among others her donation of a
parcel of land in favor of our sister RICHELLE EGUIA
BAYNO-BRIONES, containing an area of 243 square meters
and situated at Purok Anahaw, Brgy. Buhangin, Davao City;
yyyyyyyyy) The said property my mother donated to my sister

is described under Transfer Certificate of title No. T-233770 of
the Register of Deeds for Davao City;
zzzzzzzzz) I hereby waive all my rights and interests over the

above-described property unto and in favor of my sister
mentioned above; and
aaaaaaaaaa) That this affidavit is made in good faith and

that I executed this presents voluntarily, freely, and without
mental reservations and with full knowledge of my rights
under the law.
IN WITNESS hereof, we have hereunto affixed our signatures this ____ th day of
June, 2011 in the City of Davao, Philippines.
JAVIER E. BAYNO
Affiant
SUBSCRIBED AND SWORN to before me this _____ th day of June, 2011,

________________________________
Doc. No. _________;

Page No. _________;
Book No. _________;
Series of 2011.
In the City of Davao . . . . . . . . . . . . )ss
x------------------------/
A F F I D A V I T
I, LILIBETH T. UY, of legal age, Filipino, married and a resident of Mango St., St. Michael,
Daliao, Toril, Davao City, Philippines, under oath, depose and say:
bbbbbbbbbb) I am the PUBLISHER of MINDANAO MERCURY

TIMES, a newspaper of general circulation in Mindanao with Editorial
Office at Mango St., St. Michael, Daliao, Toril, Davao City;
cccccccccc) That MINDANAO MERCURY TIMES is accredited by the

Office of the Regional Trial Court to publish Legal Notices, Extra-
Judicial Sale of Foreclosure, Notice of Invitation to Bid and to
Prequalify and other notices for publication and to participate in any
raffling/bidding of publication;
dddddddddd) That at the instance the DEED OF

EXTRAJUDICIAL SETTLEMENT OF ESTATE WITH
RECONVEYANCE and/or WAIVER AND LIFETIME USUFRUCT
among the HEIRS OF NAPOLEON S. SIPALAY, SR.;
eeeeeeeeee) That the order of the publication of LEGAL

NOTICE;
ffffffffff) That NOTICE IS HEREBY given that the estate of the late
NAPOLEON S. SIPALAY, SR. who died intestate on February 6, 2005
in Davao City, left two (2) parcels of land embraced in Transfer
Certificate of Title Nos. T-146418 and T-297648 of the Registry of
Deeds for Davao City, at the subject of the Deed of said Extra-judicial
Settlement of Estafa with Reconveyance and/or Waiver and Lifetime
Usufruct as per Doc. No. 59; Page 12; Book No. 19; Series of 2010 of
the Notarial Registry of Atty. Jacinto L. Legaspino.
gggggggggg) That it has been published in the above-mentioned

newspaper and can be verified in the issued of April 18, 25 & May 2,
2011;
IN WITNESS hereof, we have hereunto affixed our signatures this 27 th day of May, 2011
LILIBETH T. UY
Affiant
had voluntarily executed and understood the foregoing.
______________________________________
Doc. No. ___________ Notary Public
Page No. ___________
Page No. ___________
Series of 2011.
SECRETARY'S CERTIFICATE
1. That I am the Corporate Secretary of TIRE SMART Car Accessories with office
address at Tiongko St. corner Araullo St., Davao City;
2. That at a duly convened meeting of the Board of Directors held last March 21,
2011, where a quorum was present, the following resolution was unanimously approved, to
wit:
"RESOLVED, that Ms. NILDA L. GUADALQUIVER, the Company’s
Account Receivable Officer, be authorized, as she is hereby duly authorized
to represent the company in its collection, to demand, sue and/or initiate any
legal action, civil or criminal, and further to sign for and in behalf of the
corporation any and all papers and documents relative thereto, to enter into
compromise agreement with any party/parties, including dismissal of the
complaint filed."
3. That the foregoing resolutions are true and correct and that it has not been
amended or superseded up to this date.
IN WITNESS WHEREOF, I have hereunto set my hand this 31 st day of March,
ROCKY ROY V. CABILES

Signature of Corporate Secretary
Acknowledgment

Davao City . . . . . . . . . . . . . . . . . . . . . . . ) S.S.
X-----------------------------/
BEFORE ME , a Notary Public, for and in the City of Davao, Philippines, the
parties above personally appeared exhibiting his valid identification card, known to
me and to me known to be the same person who executed this instrument and
acknowledged to me that the same is his free act and deed.
WITNESS MY HAND AND SEAL at the date and place first given above.
Doc. No . __________;
Page No. __________;
Book No.__________;
Series of 2011.
Revocation
Of Special Power Of Attorney
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, I, NEPOMOCENO O. BALANSAG, SR., of legal age, Filipino,

married to Buenaventurada M. Balansag and a resident of Davao City, Philippines,
by a certain instrument, SPECIAL POWER OF ATTORNEY, made and executed in
Naawan, Misamis Oriental, sometime in 2006 or 2007, did name, constitute and
appoint NEPOMOCENO M. BALANSAG, JR., a resident of Mansabay, Lopez Jaena,
Misamis Occidental, Philippines, my true and lawful attorney-in-fact, for the purpose
and with powers mentioned in said public instrument;
WHEREAS, the said public instrument or Power of Attorney, was submitted to

MINE DOMAIN, INC., Magpor, Upper Malubog, Manticao, Misamis Oriental;
NOW, THEREFORE, I, NEPOMOCENO O. BALANSAG, SR., by virtue of

these presents, do hereby REVOKE, ANNUL and MAKE VOID the said authority
and all powers and any other authority therein or thereby given or granted unto
said NEPOMOCENO M. BALANSAG, JR.
IN WITNESS WHEREOF, I have hereunto set my hand this JANUARY 14,

NEPOMOCENO O. BALANSAG, SR.

Principal
BUENAVENTURADA M. BALANSAG
Wife
Signed in the presence of:
_____________________________ & _____________________________
Acknowledgment
Davao Ctiy . . . . . . . . . . . . . . . . . . . . . . . ) S.S.
X-----------------------------/
parties above personally appeared exhibiting their respective valid identification
cards, both known to me and to me known to be the same persons who executed
this instrument and acknowledged to me that the same is their free act and deed.
Doc. No . _201______;
Page No. __91______;
Book No.__XVII____;
Series of 2011.

) S.S.
Davao City . . . . . . . . . . . )
x--------------------/
With Waiver Of Rights
We, EMMA C. DOMINISE, HERMAN C. DOMINISE, REYNALDO C.

DOMINISE and ANNE DOMINISE-AGUILAR, all of legal age, Filipino, and
residents of Davao City, Philippines, after having been sworn to in
11. That we are the surviving legitimate children and heirs of the
deceased/ensured BRUNO RODRIGO DOMINISE who died
on December 23, 2010 in Davao City;
12. That during his lifetime, he has applied and is an ensured for
insurance coverage pursuant to PCA Administrative Order No.
02, and as such, we, the beneficiaries are entitled for benefits;
13. That we hereby adjudicate among ourselves the said benefit;
14. That we, EMMA C. DOMINISE, REYNALDO C. DOMINISE

and ANNE DOMINISE-AGUILAR, hereby waive our
respective rights in favor of our brother, HERMAN C.
DOMINISE, to whom we authorize to claim the proceeds of
any amount, check or cash, as beneficiaries of the deceased
Bruno Rodrigo Dominise;
15. That we are executing this affidavit to attest to the truth of

the foregoing facts and to submit the same to the authorities
concerned for purposes of adjudication and/or withdrawal of
any amount due to us from the PCA in favor of our sibling
Herman C. Dominise;
16. That we hereby set the PCA free and faultless and solely hold
ourselves liable should a conflict arise in our claim of benefits.
IN WITNESS WHEREOF, we have hereunto set our hands this

_______________________ at Davao City, Philippines.
Conforme:
HERMAN C. DOMINISE EMMA C. DOMINISE

Affiant Affiant
REYNALDO C. DOMINISE ANNE DOMINISE-AGUILAR

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this _____________________, in
the affiant and that I am satisfied that the affiants have voluntarily executed
and understood the foregoing affidavit.
Doc. No . __________;
Page No.__________;
Book No.__________;
Series of 2010.
Revocation
Of Special Power Of Attorney
That we, ROBERT PANTOJA PEREDA, DELIA PANTOJA PEREDA-PAMANI,

ROSEMARIE PANTOJA PEREDA-BIÑAS and RACHEL PANTOJA PEREDA, all of
legal age, Filipino and residents of Davao City, do hereby REVOKE, ANNUL and
MAKE VOID any authority or document we have purportedly executed in favor of
JOSEPH Y. PANTOJA, of legal age, Filipino, married and a resident of Datu Abdul,
Panabo City, particularly SPECIAL POWER OF ATTORNEY dated September 26,
1998 notarized by Atty. Mariano Alegarbes, entered in his Notarial Book as Doc. 394,
Page No. 79, Book VI, Series of 1998, the same document we have not
executed before any person authorized to administer
oath.
That notice is hereby given to Davao Agricultural Ventures Corporation
(DAVCO) and Evergreen Farms, Incorporated (EFI) that the said authority had is
hereby revoked and any transaction entered into by Joseph Pantoja all not be
honored by the heirs of Severino Pantoja and Conrada Pantoja.
IN WITNESS WHEREOF, we have hereunto set my hand this 21 st day

of September 2006 at Davao City, Philippines.
ROBERT P. PEREDA DELIA P. PAMANI

Affiant Affiant
CTC No. 26338801 CTC No. 26375301
Issued on 01-04-11 Issued on 01-03-11
At Davao City At Davao City
ROSEMARIE P. BIÑAS RACHEL P. PEREDA

Affiant Affiant
CTC No. 26375767 CTC No. 24534983
Issued on 01-04-11 Issued on 01-04-11
At Davao City At Davao City
_____________________________ & _____________________________
Acknowledgment
Davao Ctiy . . . . . . . . . . . . . . . . . . . . . . . ) S.S.
X-----------------------------/
parties above personally appeared exhibiting their respective Community Tax
Certificates, all known to me and to me known to be the same persons who
executed this instrument and acknowledged to me that the same is their free act
and deed.
Doc. No . __________;
Page No.__________;
Book No.__________;
Series of 2010.
AFFIDAVIT OF ACCIDENT

x------------------------/
I, EDIFLOR R. YANONG, of legal age, Filipino, single and a resident of Blk. 18, Lot 9, Susana
Homes lll, Baliok Talomo District, Davao City, Philippines, after having been sworn to in accordance with
1. That I am a sales representative of SANOFI SYNTHELABO PHILS., INC., and as such,

I was provided a motor vehicle for service, the particulars of which are as follows:
MAKE/TYPE NISSAN SENTRA SEDAN

MOTOR NO. QG13-000888
SERIAL/CHASSIS NO. CDEALDFN16-A72934
FUEL GAS
COLOR SILVER
PLATE NO. XLM-914
2. That on or about April 9, 2008, while my said car was parked unattended outside of my
residence, I discovered the left tail light was broken and left portion of
the rear bumper incurred scratches;
3. That efforts to ascertain the perpetrator proved to no avail;
insurance purposes.
EDIFLOR R. YANONG
Affiant
SUBSCRIBED AND SWORN TO before me this 11th day of June, 2008 in the City of Davao,
To explain
discrepancy in AFFIDAVIT OF RECONCILIATION OF BIRTH
birth certificate
against other DATA
documents
I, ANA RECAFRANCA, of legal age, single and with residence address at _____,
after being duly sworn to according to law, hereby depose and state:
1. That I am the daughter of the couple ____ and _____ of Calbayog City and I
was born on May 9, 1966;
2. That in the birth certificate which I obtained only recently, my family name is
spelled as "Recafranca" instead of "Ricafranca" to which I have I have been used to as in
my school records, SSS, BIR and other public documents;
3. That a copy of said birth certificate which indicated my family name as
"Recafranca" is hereto attached for reference;
4. That the names Ana Recafranca and Ana Ricafranca belong to one and the
same person, the undersigned herein;
5. That I am executing this affidavit in order to attest to the truth of foregoing
circumstances and for the purpose of setting the records straight and declaring that Ana
Recafranca and Ana Ricafranca refer to one and the same person.
IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of May, 2003
at the City of Mandaluyong.
Signature of Affiant

x--------------------/
Affidavit of Accident
I, RONALD LAYSON QUIJANO, of legal age, Filipino, married and a resident of No. 83
Ruby St., Pampanga, Lanang, Davao City, after having been duly sworn to in accordance with
1. That I am a holder of Professional Driver License with Number LO2-96-
116142 issued on March 22, 2002 and to expire March 22, 2005;
2. That on or about August 7, 2004, at around 5:30 in the afternoon, while

driving a TS 100 Suzuki motorcycle, a Conpinco Trading Corporation service
vehicle, along Bajada, Davao City, coming from our office at corner
Iñigo/Bajada, heading towards north, when upon reaching the vicinity fronting
Victoria Plaza, Bajada, I maneuvered to avoid collision with the right side
door of a taxi cab which was suddenly opened by the passenger;
3. That as a result thereof, I crashed to the gutter of the road and I was thrown
away sustaining minor injury and incurring minor damage on the motorcycle;
4. I am I am executing this affidavit to attest to the foregoing facts and to submit

the same to the authorities concerned, particularly to the Social Security
System (SSS), Bajada, Davao City, for whatever purpose this may serve to
avail sick leave benefits.
IN WITNESS WHEREOF, I have hereunto set my hand this 10 st of August, 2004 at the
RONALD L. QUIJANO
Affiant
SUBSCRIBED AND SWORN to before me this 10t day of August, 2004, in the City of

City/of Davao - - - - - - - - - ) S.S.
x-----------------x
I, JASMICRISTY VALLESCAS REDA, of legal age, Filipino, married and a

resident of 83 Ulas, Davao City , after having been sworn to in accordance with law,
depose and say that:
29.) I am the VENDEE of two (2) Deeds of Sale entered into by me and Evangeline Saron
Concepcion, the VENDOR;
30.) The first Deed of Sale (Attached herewith as Annex “A”) was executed by VENDOR
Evangeline Saron Concepcion in my favor on May 9, 2009. The lot sold in my favor
consisting of One Hundred Sixty Two (162) square meters is part of a parcel of land
covered by Transfer Certificate of Title No. T-436961. The technical description of the
said lot is expressly stated in the said Deed of Sale.
31.) The second Deed of Sale (Attached herewith as Annex “B”) was executed by VENDOR
Evangeline Saron Concepcion in my favor on September 9, 2012. However, as early as
September 26, 2010, the purchase price of the said lot was already fully paid by the VENDEE.
The lot sold in my favor consisting of Two Hundred Seventy Three (273) square
meters is part of a parcel of land covered by Transfer Certificate of Title No. T-436961.
The technical description of the said lot is expressly stated in the said Deed of Sale.
32.) As such the VENDOR Evangeline Saron Concepcion has since then relinquished all her
rights, interests and participation over the aforesaid lots in my favor, the VENDEE.
33.) However, it has come to my knowledge that the parcel of land covered by Transfer
Certificate of Title No. T-436961 which includes my two (2) lots, was mortgaged by
VENDOR Evangeline Saron Concepcion to a certain Albert D. Vasquez for Five Hundred
Thousand Pesos (PHP 500,000.00) on March 5, 2012, WITHOUT MY KNOWLEDGE AND
CONSENT as evidenced by its annotation in the said title. (a CERTIFIED COPY of which is
hereby attached as Annex “C”);
34.) My ownership to the said lots precedes that of the date of the mortgage. Hence, when it was
mortgage, the VENDOR did not have the authority for as early as September of 2010, I was
and still is the legal and lawful owner of the said lots.
35.) Unless an adverse claim is annotated on the aforesaid Transfer Certificate of Title, I, who is
the legal owner of the said lots is in danger of being defrauded and deprived of my just and
valid right over the aforesaid parcel of land.
36.) As such, I am executing this Affidavit in support of my request for the

annotation of an adverse claim over the parcel of land described herein.
37.) FURTHER AFFIANT SAYETH NAUGTH.

September, 2012, in the City of Davao, Philippines.
JASMICRISTY VALLESCAS REDA

Affiant
SUBSCRIBED AND SWORN TO before me this 13th day of September, 2012, in

the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiants
and that I am satisfied that she voluntarily executed and understood the foregoing
affidavit.
________________________________
To Adjudicate
DLPC Account AFFIDAVIT OF ADJUDICATION

x-------------------/
Affidavit Of Adjudication
With Undertaking
I, FLORENTINO, JR. BALAGULAN Y ANTEQUINA, 34 years of age, Filipino, married and a

resident of Doña Asuncion Village, Bo. Pampanga, Lanang, Davao City, Philippines, after having
13. That I am among the four (4) surviving children of the deceased
FLORENTINO BALAGULAN, SR., who, during his lifetime is the registered
consumer of a Davao Light & Power C. Inc. (DLPC) electrical connection
under Account No. 0912146590;
14. That my father died without a will, and since I am now the one paying the
electrical bills, with the conformity of my siblings, I hereby adjudicate the
said electrical connection, and request for the transfer of the account to my
name;
15. That I hereby agree to indemnify and/or hold the DLPC, its officers and staff,
free and harmless from any suit, claim, expense, damage or liability, it or
they may incur/suffer through or in connection with my request for transfer
of the account No. of my father to my name;
and to submit the same to the DLPC for my request of transfer of account
number to my name.
IN WITNESS WHEREOF, we have hereunto set our hands this 24 th day of July, 2007 at
Conforme:
AMYLITA B. AMARANTE FLORENTINO A. BALAGULA, JR.

sister Affiant
JULIETA B. MATARLO
Sister
VIRGINIA B. MANSERAS
sister
SUBSCRIBED AND SWORN to before me this 20 th of July, 2007, in the City of Davao,
Philippines and I further certify that I have personally examined the affiants and I am satisfied
that they voluntarily executed and understood the foregoing affidavit.
________________________________________
Retirement of
Business Permit BUSINESS PERMIT
x--------------------/
Affidavit Of Buisiness Permit

Retirement
I, ______________JOSEPHINE B. OMICTIN, of legal age, Filipino, married and a

resident of Mintal, Davao City, Philippines (infront of Phil. Science), after having been duly
1. That I am a holder of Business Permit No. B-25552-2 for Retailer of Coco

Lumber, issued by the Business Bureau of Davao City;
2. That for reason of lack of capital and loss, I ceased operation sometime in
January 20, 2000;
3. That as such, there was no more income derived from said business from
January 20, 2000 to date;

averments and to submit the same to the Business Bureau of Davao City for
purposes of retirement of my business permit.
IN WITNESS WHEREOF, we have hereunto set our hands this 30 th day of July 2004 at
JOSEPHINE B. OMICTIN
Affiant
SUBSCRIBED AND SWORN to before me this 30 th day of July, 2004, in the City of
satisfied that she had voluntarily executed and understood her affidavit.

x--------------------/
Affidavit Of Non-Operation
Of Buisiness
I, CARMEN DALO VDA. DE LIM, of legal age, Filipino, widow and a resident of No. 5,
Busytone St., PLDT Village, Talomo, Davao City, Philippines, after having been duly sworn to in
1. That sometime in 2003, I have applied for Business Permit to operate a sari-
sari store for Retailer of General Merchandise, Fermented Liquor,
Cigarette and Rice at my place of residence;
2. That however, because of the death of my husband, I have had incurred

financial problems, and as such, I failed to operate my business;
3. That it was only sometime in March 2004 that I decided to operate again the
said business;
4. That as such, since there was not actual operation of my business for the
period 2003 to February, 2004, there was no income derived;

averments and to submit the same to the Business Bureau of Davao City for
purposes of renewal of business permit; and
6. That since my capital is not sufficient to operate all the natures described in
my business permit, I hereby request the Business Bureau to delete
FERMENTED LIQUOR, CIGARETTES and RICE in my Business Permit
and retain only GENERAL MERCHANDISE.
IN WITNESS WHEREOF, we have hereunto set our hands this 19 TH of August 2004 at
CARMEN DALO VDA. DE LIM

Affiant
SUBSCRIBED AND SWORN to before me this 19TH of August 2004, in the City of
AFFIDAVIT OF COHABITATION

x------------------------/
Joint Affidavit
(Cohabitation)
We, ____________________ and __________________, both of legal age, Filipino, single and
residents of _________________, Davao City, Philippines, respectively, after having been sworn to in
3. That with our relationship, we have been blessed with one (1) child, ______________.
She is now _____________ years old. Photocopy of her/his Birth Certificate is hereto
attached;
IN WITNESS hereof, we have hereunto affixed our signatures this ______ th day of
___________________________, ____________, in the City of Davao, Philippines.
Affiant Affiant
CorroboratIon
We, ____________________ and __________________, both of legal age, Filipino, single and
residents of _________________, Davao City, Philippines, respectively, after having been sworn to in
1. That the statements above made by the affiant are true and correct to the best of our
IN WITNESS hereof, we have hereunto affixed our signatures this ______ th day of
_________________, ____________, in the City of Davao, Philippines.
Affiant Affiant
SUBSCRIBED AND SWORN TO before me this ______ th day of _____________, ________, in

the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am
satisfied that they have voluntarily executed and understood the foregoing affidavit..
AFFIDAVIT OF CONSENT

x - - - - - - - - - - - - - /
I, ___________________, of legal age, Filipino, widow and a

resident of Baracatan, Toril, Davao City, Philippines, after having
yyyyy) That I am the parent of ________________ who was

born on _________________ in Davao City;
zzzzz) That she is now twenty three (23) years of age

and desires to marry a man of her choice, TAKAYOSHI
HONDA, a Japanese national who is now in Japan;
aaaaaa) That having acquainted with her fiance’, and

knowing our child to be of age, of sound mental and
physical health, and could take care a family of her
own, I am granting her my parental consent for her
marriage;
bbbbbb) That I am executing this affidavit to attest the

same to the authorities concerned for whatever purpose
this may serve to my child’s intended marriage with
TAKAYOSHI HONDA.

________, , in the City of Davao, Philippines.
Affiant
SUBSCRIBED AND SWORN TO before me this ________day of _______, in

the City of Davao, Philippines, and I HEREBY CERTIFY that I have
examined the affiant and that I am satisfied that she had voluntarily
executed and understood the foregoing affidavit.
________________________________
Doc. No. _______________

Page No. _______________
Book No. _______________
Series of 2007.

x------------------------/
I, DOMINGO MAJESTRADO Y PERROZ, of legal age, Filipino, widow and a

resident of Purok 6, Piñano St., Calinan, Davao City, Philippines, after having been
cccccc) That I am the father of ROSELL TITO MAJESTRADO;
dddddd) That she was born July 3, 1981 in Davao City, and she is
now 25 years of age;
eeeeee) That she is intending to marry a man of her choice, TORU

KURAHASHI, a Japanese national;
ffffff) That having acquainted with her fiancé, and knowing my

daughter to be of age, of sound mental and physical health, I am
granting my parental consent to her intended marriage with Toru
Kurahashi;
gggggg) That I am executing this affidavit to attest the truth of the

concerned for whatever purpose this may serve to my intended
marriage of my daughter.
IN WITNESS HEREOF, I have hereunto affixed my signature this 3 rd day of

DOMINGO P. MAJESTRADO
Affiant
SUBSCRIBED AND SWORN TO before me this 3rd day of October, 2006, in the
and that I am satisfied that he voluntarily executed and understood the foregoing
affidavit.
________________________________
Doc. No. _______________

Page No. _______________
Book No. _______________
Series of 2006,
AFFIDAVIT OF DEPENDENCY
x--------------------/
Affidavit of Dependency
I, ROMUALDA CAMINSE VDA. DE RAMIREZ, of legal age, Filipino, widow and a

resident of Mandug, Buhangin District, Davao City, after having been duly sworn to in
17. That I am was born on February 7, 1939 and is now sixty seven (67) years
old;
18. That I have no means of support, and since the death of my husband in
November 3, 1972, I have been a dependent of my youngest son, MARCELO
CAMINSE RAMIREZ, financially;
19. That my son died single on September 9, 2004 at the Davao Medical Center,
Bajada, Davao City;
20. That I am executing this affidavit to attest to the foregoing facts and to submit
the same to the Social Security System (SSS), Davao City, for whatever
purpose this may serve to my intent to claim death benefits.
21. That I understood that any false statement in this affidavit shall cause denial
of my claim.
IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of September, 2004
ROMUALDA C. RAMIREZ
Affiant
SUBSCRIBED AND SWORN to before me this 29 th day of September, 2004, in the City
AFFIDAVIT OF DISCREPANCY
x------------------------/
I, EMMA NG Y CRUZ, of legal age, Filipino, married and a resident of Davao City,
1. That I and my husband are the co-proprietors of J AGROTRADE, a business

dealing with the retail and wholesale of rice and corn;
2. That among our employees is one MARY GRACE NAQUITQUITAN who have
just been employed last June 1, 2004;
3. That as such, in compliance with the Social Security Law, we have undertaken
registration for membership of our said employee with the Social Security
System (SSS), Davao City;
4. That on July 8, 2004, I filed FORM R-1A indicating only the name of our said
employee, however, in the Date Of Employment space I have inadvertently
type written 01 2004 only, day and year, of his supposed-to-be start of
employment. It should have been 06 01 2004;
4. That the error is a plain oversight on the part of the undersigned;
5. That I am executing this affidavit to attest to the truth of the foregoing facts and
to submit the same to the Social Security System, Bajada, Davao City, for
whatever purpose this may serve to the purpose for the registration of our
new employee.
IN WITNESS hereof, we have hereunto affixed our signatures this ____ th day of August,
Conformity:
MARY GRACE Z. NAQUITQUITAN EMMA C. NG

Affiant/Employee Affiant
J AGROTRADE Proprietor
SUBSCRIBED AND SWORN TO before me this ______ th day of August, 2004, in the
am satisfied that the affiants have voluntarily executed and understood the foregoing affidavit..
To explain
discrepancy in AFFIDAVIT OF RECONCILIATION OF BIRTH
birth certificate
against other DATA
documents
I, ANA RECAFRANCA, of legal age, single and with residence address at _____,
after being duly sworn to according to law, hereby depose and state:
1. That I am the daughter of the couple ____ and _____ of Calbayog City and I
was born on May 9, 1966;
2. That in the birth certificate which I obtained only recently, my family name is
spelled as "Recafranca" instead of "Ricafranca" to which I have I have been used to as in
my school records, SSS, BIR and other public documents;
3. That a copy of said birth certificate which indicated my family name as
"Recafranca" is hereto attached for reference;
4. That the names Ana Recafranca and Ana Ricafranca belong to one and the
same person, the undersigned herein;
5. That I am executing this affidavit in order to attest to the truth of foregoing
circumstances and for the purpose of setting the records straight and declaring that Ana
Recafranca and Ana Ricafranca refer to one and the same person.
at the City of Mandaluyong.
Signature of Affiant
To explain
discrepancy in
birth certificate AFFIDAVIT OF RECONCILIATION OF
against other
documents
BIRTH DATA

x------------------------/
Joint Affidavit
(Discrepancy)
We, _____________________ and _____________________, both of legal age, Filipino,

married and residents of _____________________________, Davao City, Philippines, respectively, after
1. That we personally know the person ______________________________;
2. That she is the second of the two (2) illegitimate children of ________________ with
Cedric Villanueva;
3. That she was baptized Catholic at Sto. Rosario Parish of Toril, Davao City, however, in
the Certificate of Baptism, her family name registered is that of her father’s family
name which is VILLANUEVA. It should have been MAYDA, the family name of her
mother because her parents were not married;
3. That Chariza Mae Villanueva per Certificate of Baptism, and Chariza Mae Lopez
Mayda per Certificate of Live Birth, refer to one and the same person whose true
name being an illegitimate child of the above-mentioned Gilda Mayda and Cedric
Villanueva, is CHARIZA MAE LOPEZ MAYDA;
neighbors with the spouses Camacho for a long time in our place of residence prior to
their transfer to Makati City where Jose Teodoro Cesar died of heart ailment;
5. That we are not related either by affinity or by consanguinity and that we have interest
of whatsoever;
submit the same to the authorities concerned for whatever purpose this may serve.
IN WITNESS hereof, we have hereunto affixed our signatures this 9 th day of August, 2004, in the
MARIA FE GLENN GODITO

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 9 th day of August, 2004, in the City of Davao,
AFFIDAVIT OF GUARDIANSHIP

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
And Consent
I, F________________, of legal age, Filipino, married/widow and a resident of

___________________, Philippines, after having been duly sworn to in accordance with law, do
22. That I am the uncle of _________________;
23. That he is the child of spouses Felimon Basister (my brother) and Lolita
Velozo who was born on April 18, 1980 in Natividad, Binucayan, Loreta,
Agusan del Sur;
24. That she has been under my guardianship since her parents are in
Agusan;
25. is now twenty four (24) years old and is intending to marry Dandy Albarico
who is thirty two (32) years;
26. That knowing that my niece is of age and knowing that Dandy Albarico
comes from a good family, single and has no legal impediment, gainfully
employed can capable of raising a family of their own, I am giving my consent
to their intended marriage;
purpose this may serve to the marriage of my niece with Dandy Albarico.
IN WITNESS WHEREOF, I have hereunto set my hand this _____ th day of ___________
Affiant
SUBSCRIBED AND SWORN to before me this _____ th day of ___________, in the City
AFFIDAVIT OF HEIRSHIP

) S.S.
Mati, Davao Oriental . . . . )
x------------------/
Declaration of Heirship
We, VICTORIANO GUMOBAO, LAURA GUMOBAO, DOMINGO GUMOBAO, CELSO GUMOBAO,

ANGELITA GUMOBAO-CARAEL, DARWIN M. GUMOBAO, ELIEZER GUMOBAO and VIRGENCITA
GUMOBAO-CUIZON, all of legal age, Filipinos, married and a residents of Caraga, Davao
Oriental, respectively, after being sworn to law, depose and say;
1. That we are the heirs of the late Elpidio Gumobao, who during his lifetime has
acquired a 36,045 square meter property at Caraga, Davao Oriental;
2. That before being acted upon, our said brother died, and we substituted as
applicants, being the heirs of Elpidio Gumobao, represented by Anatalio
Gumobao, one of our siblings, who also died later and is survived by his
children, Domingo Gumobao and Laura Gumobao, likewise affiants herein;
3. That, thereafter, a title was issued for the aforementioned lot applied for
under the name Heirs of Elpidio Gumobao, represented by Anatalio
Gumobao, as per Original Certificate of Title No. P- 7950 of the Registry
Deeds for the Province of Davao Oriental;
4. That we hereby declare under oath, that we are the very same Heirs of
Elpidio Gumobao, registered owner of the aforementioned parcel of land;
5. That we are executing this affidavit to attest to the truth of the foregoing facts
and to submit the same to the Office of the Register of Deeds for Davao
Oriental for whatever purpose this may serve to our declaration of heirship of
the above-mentioned property.
IN WITNESS WHEREOF, we have hereunto affixed our signatures this ____ th

_____________________, 2004 at Mati, Davao Oriental, Philippines.
VICTORIANO GUMOBAO LAURA GUMOBAO DOMINGO GUMOBAO

Affiant Affiant Affiant
CELSO GUMOBAO ANGELITA G. CARAEL DARWIN M.

GUMOBAO
ELIEZER GUMOBAO VIRGENCITA GUMOBAO-CUIZON

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this _______ th day of _______________,

2004, at Mati, Davao Oriental, Philippines, and I HEREBY CERTIFY that I have examined the
affiants and that I am satisfied that they have voluntarily executed and understood the foregoing
affidavit..
AFFIDAVIT OF HEIRSHIP AND

ADJUDICATION

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
And Adjudication
We, ORVILLE E. NAPOLES, ELSIE NAPOLES GUTIERREZ, LARRY E. NAPOLES,

REZEL NAPOLES-SCHUMACHER, LIZA E. NAPOLES, ARIEL E. NAPOLES and RENATO E.
NAPOLES, all of legal age, Filipino, and residents of Davao City, Philippines, after having been sworn to
17. That we are the legitimate children and heirs of the late Generoso E. Napoles and
Mesaila M. Española;
18. That during their marital union, our father, Generoso E. Napoles, had opened a
savings account at the Land Bank of the Philippines (LBP) under Savings
Account Number 1471-0446-16 and, to date, has an outstanding balance of Five
Thousand Six Hundred Sixty Four Pesos and Ninety Six Centavos
(Php=5,664.96);
19. That our father Generoso E. Napoles died on July 19, 2004 without a will;
20. That as such, we hereby adjudicate among ourselves the said savings account of our
father, and we are waiving our respective right in favor of our brother, ARIEL E.
NAPOLES, to whom we authorize to claim the proceeds of our father’s account with
the LBP, San Pedro St. Branch, Davao City;
submit the same to the Land Bank of the Philippines for purposes of adjudication
and/or withdraw the said savings account of our deceased father.
22. That we hereby set the LBP free and faultless and solely hold ourselves liable should a
conflict arise in our claim of the said savings account balance.
IN WITNESS WHEREOF, we have hereunto set our hands this ____________, 2005 at Davao
City, Philippines.
Conforme:
ARIEL E. NAPOLES ELSIE N. GUTIERREZ ORVILLE E. NAPOLES

Claimant Affiant Affiant
LARRY E. NAPOLES REZEL N. SCHUMACHER LIZA E. NAPOLES

RENATO E. NAPOLES ARIEL E. NAPOLES

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this ____ th day of _________, 2005, in the City of
Davao, Philippines, and I HEREBY CERTIFY that I have examined the affiant and that I am satisfied that
the affiants have voluntarily executed and understood the foregoing affidavit..
****************
AFFIDAVIT OF INCOME
x--------------------/
Affidavit Of No Other Income
I, RODRIGO SUELA GANADEN, of legal age, Filipino, married and a resident of

Subasta, Calinan, Davao City, Philippines, after having been duly sworn to in accordance with
7. That I, being a carpenter and my spouse Lolita Iranon Ganaden, a housewife,

has low income for the year 2007;
8. That I son RODMARK IRANON GANADEN is applying for scholarship with

the University of Mindanao;

averments and to submit the same to the Bureau of Internal Revenue, for
whatever purpose this may serve to my intent to secure Certificate of No
Income.
IN WITNESS WHEREOF, we have hereunto set our hands this 10 rd day of July, 2008 at
RODRIGO S. GANADEN
Affiant
SUBSCRIBED AND SWORN to before me this 10 rd day of July, 2008, in the City of
satisfied that he had voluntarily executed and understood her affidavit.
&&&&&&&&&&&&&&&&&&&

x--------------------/
Affidavit Of No Other Income
I, BRYNALD CATAYAS BARUG, of legal age, Filipino, married and a resident of Green
Meadows, Mintal, Davao City, Philippines, after having been duly sworn to in accordance with
10. That I am a professional driver by profession;
11. That I earn my living driving my own Multicab utility vehicle with route Matina-
Agdao;
12. That I have no other income of whatsoever, the same to support my family of
two (2) children;
IN WITNESS WHEREOF, we have hereunto set our hands this 3 rd day of August 2004 at
BRYNALD C. BARUG
Affiant
SUBSCRIBED AND SWORN to before me this 3 rd day of August, in the City of Davao,
that he had voluntarily executed and understood her affidavit.
****************

x--------------------/
Affidavit Of Marginal Income
I, BONIFACIA C. CERVANTES, of legal age, Filipino, married and a resident of Km. 8,

Tigatto, Buhangin, Davao City, Philippines, after having been duly sworn to in accordance with
14. That I am an owner of the following motorcycle, the particulars of which are
as follows;
MAKE/TYPE SUZUKI W/CAB

MOTOR NO. G104-135850
SERIAL/CHASSIS NO. GP125-124749
FUEL MIX
COLOR BLUE
PLATE NO. LY-1587
FRANCHISE NO. 03-0392
15. That I am a marginal income earner with Php=12,000.00 gross annual

income;
16. That I and my spouse have no other income of whatsoever, nor are we
employed in any company or office;
IN WITNESS WHEREOF, we have hereunto set our hands this 3 rd day of July, 2007 at
BONIFACIA C. CERVANTES
Affiant
SUBSCRIBED AND SWORN to before me this 3 rd day of July, 2007, in the City of
****************
AFFIDAVIT OF LANDHOLDING

x--------------------/
Affidavit of Landholding
I, _________________, of legal age, Filipino, married to ______________ and a resident of

________________, Davao City, Philippines, after having been duly sworn to in accordance with law, do
22.That I am now the new owner of a parcel of land situated at Bo. Fatima, Paquibato,
Davao City, covered by Transfer Certificate of Title No. T-53360 of the Registry of
Deeds for Davao City, the particulars of which are as follows:
“Beginning at a point marked “1” of Lot 101, of Gss-824, bineg N. 20-17 W.,
1521.05 m. from BM.B.M. No. 1, Cad. 174, t h e n c e . . . . . .
S. 71-28 E., 156.54 m. to point 2; S. 47-42 W., 316.63 m. to point 3;
N .52-08 E., 137.25 m. to point 4; N. 69-15 E., 43.02 m. to point 5;
N. 36-22 E., 151.27 m. to point 6; N. 57-03 E., 76.48 m. to point 1;
Point of beginning. Containing an area of THIRTY NINE THOUSAND FOUR
HUNDRED ANDTWENTY SIX (39,426) SQUARE METER. X.x.x .”
23.That I, jointly with my wife, have no landholding other than the above-described
property;
24.That I am executing this affidavit to attest to the truth of foregoing facts and to submit
the same to the authorities concerned for whatever purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this ______ th day of __________, _____,
Affiant
SUBSCRIBED AND SWORN to before me this ______ th day of __________, _____, in the City of
Davao, Philippines and I further certify that I have personally examined the affiant and I am satisfied that
he/she voluntarily executed and understood his affidavit.
AFFIDAVIT OF IMPROVEMENT

) S.S.
Davao City . . . . . . . . . . . )
x------------------/
Affidavit
Of No Improvement
I, __________________, all of legal age, Filipino, married/widow and a resident of

_____________________, Davao City; Philippines, after having been duly sworn to in
28. That I am the registered owner of a parcel of land situated in the Barrio of
_________________, _________________, Island of Mindanao, containing
an area of _________________________ (____) SQUARE METERS, more
or less, my title thereto being evidence Transfer Certificate Of Title No.
_________________ of the Registry of Deeds for Davao City;
29. That the said parcel of land has no improvement of whatsoever;
IN WITNESS WHEREOF, I have hereunto set my hand this ____ th day of

_____________, 2011 at the City of Davao, Philippines.
Affiant
SUBSCRIBED AND SWORN to before me this ______ th day of ________________,

2011, in the City of Davao, Philippines and I further certify that I have personally examined the
affiant and I am satisfied that he voluntarily executed and understood his affidavit.
###
AFFIDAVIT OF LEGAL CAPACITY

x--------------------/
Affidavit of Non-Tenancy
I, _________________, of legal age, Filipino, married to ______________ and a resident of
________________, Davao City, Philippines, after having been duly sworn to in accordance with law, do
25.That I am the registered owner of a parcel of land situated at Bo. Fatima, Paquibato,
Davao City, covered by Transfer Certificate of Title No. T-53360 of the Registry of
Deeds for Davao City, the particulars of which are as follows:
“Beginning at a point marked “1” of Lot 101, of Gss-824, bineg N. 20-17 W.,
1521.05 m. from BM.B.M. No. 1, Cad. 174, t h e n c e . . . . . .
S. 71-28 E., 156.54 m. to point 2; S. 47-42 W., 316.63 m. to point 3;
N .52-08 E., 137.25 m. to point 4; N. 69-15 E., 43.02 m. to point 5;
N. 36-22 E., 151.27 m. to point 6; N. 57-03 E., 76.48 m. to point 1;
Point of beginning. Containing an area of THIRTY NINE THOUSAND FOUR
HUNDRED ANDTWENTY SIX (39,426) SQUARE METER. X.x.x .”
26.That the said parcel of land is not tenanted the same being personally tilled by the
family of the undersigned owner;
27.That I am executing this affidavit to attest to the truth of foregoing facts and to submit
IN WITNESS WHEREOF, I have hereunto set my hand this ______ th day of __________, _____,
ROBERTO M. SALCEDO
Affiant
SUBSCRIBED AND SWORN to before me this ______ th day of __________, _____, in the City of
Davao, Philippines and I further certify that I have personally examined the affiant and I am satisfied that he
****************
AFFIDAVIT OF LEGITIMATION

x--------------------/
Affidavit of Legitimation
We, _______________, of legal age, Filipino, husband and wife and residents of
_________________, Davao City, after having been duly sworn to in accordance with law, do
7. That we are husband and wife having legally married on
2. That prior to our marriage, we have cohabited each other, that is, living as husband
and wife without the benefit of marriage;
3. That with said relationship, we begot two (2) beautiful children, namely:
1)
2)
4. That we hereby declare under oath that we are the legitimate biological parents of the
above-named children;
5. That we are executing this affidavit to attest to the foregoing facts and to submit the to
the Local Civil registrar of __________________, for purposes of legitimation.
IN WITNESS WHEREOF, we have hereunto set our hands this 7 th day of June 2004 at
Conformity
Mother Father
SUBSCRIBED AND SWORN to before me this 7th day of June 2004, in the City of
Davao, Philippines and I further certify that we have personally examined the affiant and I am
satisfied that they voluntarily executed and understood his affidavit.
****************
AFFIDAVIT OF LOSS

x--------------------/
Affidavit Of Loss
I, ____________________, of legal age, Filipino, married and a resident of

______________________________, Davao City, Philippines, after having been duly sworn to
28. That I am a government employee and as such, I am a member of the
Government Service Insurance System (GSIS);
29. That as such, I was issued GSIS Policy No. CM-00003398587;
30. That unfortunately, my GSIS Policy was lost in my possession and inspite of
diligent efforts exerted to locate the same could not be found;
averments and to submit the same to the Office of the Government Service
Insurance System (GSIS), Davao City, to request for a replacement of my lost
GSIS Policy.
IN WITNESS WHEREOF, we have hereunto set our hands this 30 th day of July 2004 at
________________________________
Affiant
SUBSCRIBED AND SWORN to before me this 30 th day of July, 2004, in the City of
satisfied that he had voluntarily executed and understood her affidavit.
****************
MOTOR VEHICLE_

x------------------------/
Joint Affidavit
(Change Color/Undertaking)
We, D________ and A_____________, both of legal age, Filipino, single/married and residents
of _______________ and __________, Davao City, Philippines, respectively, after having been sworn to
1. That I, _________________, am an owner of a motor vehicle, the particulars of which

are as follows:
MAKE/TYPE SUZUKI PICK-UP W/ CANOPY

MOTOR NO. 5117490
SERIAL/CHASSIS NO. DA51T-137435
FUEL GAS
COLOR WHITE
PLATE NO. MCE-143
2. That I intend to change the color of my said motor vehicle from the original WHITE to
AQUA BLUE, and as such, I contracted Mr. Arnel C. Tobias to do the job;
3. That I, ___________, a automobile painter by profession, was contracted and have

caused the change of color of the above-described vehicle for its original color to
AQUA BLUE;
4. That we are executing this affidavit to attest to the truth of the foregoing averments for
purposes of registration at the Land Transportation Office (LTO), Davao City, of the
change of color of the above-described motor vehicle; and
5. That we hereby undertake to surrender the same motor vehicle described above and
submit ourselves for investigation should a conflict arise in the change of COLOR of
the said vehicle.
IN WITNESS HEREOF, we have hereunto affixed our signatures this ___________, in the City of
Davao, Philippines.
________________________ ___________________________
Affiant/Owner Affiant/Auto Painter

****************
AFFIDAVIT OF OWNERSHIP
x------------------------/
I, _____________, legal age, Filipino, single and a resident of Block 25, Lot 38, Phase
4, Mahogany St., Green Meadows Subd., Brgy. Sto. Niño, Tugbok District, Davao City,
1. That I am an owner of a household appliances, the particulars of which are as

follows:
PENESONIC 5 CU. FT. REFRIGERATOR

Model NR-A1765FLB
Serial No. 091907459
ZEITTER & WINKLEMANN PIANO

Serial No. KH21N6ENAM MAIN-50215
SAMSUNG COMPONENT
Serial No. MAX VB550
21’ SAMSUNG TV SET

Serial No. CN203NH
7. That I have gained legal ownership of the said appliance through legal
purchase of the same at local appliance center in Davao City;
and to submit the same to the authorities concerned, for loan purposes.
IN WITNESS hereof, I have hereunto affixed my signature this ___ th day of ____, 2010,
Affiant
SUBSCRIBED AND SWORN TO before me this this ___ th day of ____, 2010, , in the
am satisfied that the affiant voluntarily executed and understood the foregoing affidavit.
_______________________________________
AFFIDAVIT OF PATERNITY

x--------------------/
Affidavit Of paternity
I, JULIUS O. DONDOY, of legal age, Filipino, married and a resident of Davao City, after
1. That I am the father of JULIE ADA MIE BELLEZA DONDOY who was born on July
6, 1988 at Panabo, Davao City, Philippines;
2. That and her mother is IMELDA BELLEZA DAGASDAS with whom I have a
common-law mutual relationship;
3. That the fact of birth of my daughter Julie Ada Mie was recorded with the Local Civil
Registry Office of Panabo City, Philippines, under LCR No. 85-2436, and that her said mother
was recorded therein as IMELDA DONDOY, although she is actually Imelda B. Dagasdas;
4. That That I hereby acknowledge my daughter Julie Ada Mie as my daughter who was
confined at the San Pedro Hospital last April 7 to 9, 2004;
5. That I am executing this affidavit to attest to the foregoing facts and to submit the to
the PhilHealth for purposes claiming refund of medical expenses.
IN WITNESS WHEREOF, I have hereunto set my hand this 28 th day of May 2004 at the
JULIUS O. DONDOY
Affiant
SUBSCRIBED AND SWORN to before me this 28 th day of May 2004, in the City of
AFFIDAVIT OF PUBLICATION

x------------------------/
A F F I D A V I T
I, JOSEPHINE I. YU, of legal age, Filipino, married and a resident of Mango St., St. Michael,
29. I am the PUBLISHER of MINDANAO MERCURY TIMES, a newspaper of

general circulation in Mindanao with Editorial Office at Mango St., St.
Michael, Daliao, Toril, Davao City;
30. That MINDANAO MERCURY TIMES is accredited by the Office of the

Regional Trial Court to publish Legal Notices, Extra-Judicial Sale of
Foreclosure, Notice of Invitation to Bid and to Prequalify and other notices for
publication and to participate in any raffling/bidding of publication;
31. That this affidavit is at the instance of the DEED OF EXTRAJUDICIAL

SETTLEMENT OF ESTATE With DEED OF SALE among the HEIRS OF
ALFREDO G. CIRUELA;
32. That the order of the publication of LEGAL NOTICE is hereby given that the
estate of the late Alfredo G. Ciruela, who died intestate on May 4, 2008 in
Davao City, left a parcel of land known and described in Transfer Certificate
of Title Nos. T-216772 of the Registry of Deeds for Davao City, as the
subject of the Deed of Extra-judicial Settlement of Deceased Person with
Deed of Absolute Sale as per Doc. No. 241; Page 49; Book No. VIII;
Series of 2011 of the Notarial Registry of Atty. Arnold V. Doria;
33. That it has been published in the above-mentioned newspaper and can be
verified in the issued of May 9, 16 & June 23, 2011;
IN WITNESS hereof, I have hereunto affixed my signature this 17 th day of June, 2011 in
JOSEPHINE I. YU
Affiant
SUBSCRIBED AND SWORN to before me this 17 th day of June, 2011, in the City of Davao,
Doc. No. ___________

Page No. ___________
Page No. ___________
Series of 2011.


x------------------------/
A F F I D A V I T
I, JOSEPHINE I. YU, of legal age, Filipino, married and a resident of Mango St., St. Michael,
34. I am the PUBLISHER of MINDANAO MERCURY TIMES, a newspaper of

general circulation in Mindanao with Editorial Office at Mango St., St.
Michael, Daliao, Toril, Davao City;
35. That MINDANAO MERCURY TIMES is accredited by the Office of the

Regional Trial Court to publish Legal Notices, Extra-Judicial Sale of
Foreclosure, Notice of Invitation to Bid and to Prequalify and other notices for
publication and to participate in any raffling/bidding of publication;
36. That at the instance the DEED OF EXTRAJUDICIAL SETTLEMENT OF

ESTATE WITH RECONVEYANCE and/or WAIVER AND LIFETIME
USUFRUCT among the HEIRS OF NAPOLEON S. SIPALAY, SR.;
37. That the order of the publication of LEGAL NOTICE;
38. That NOTICE IS HEREBY given that the estate of the late NAPOLEON S.
SIPALAY, SR. who died intestate on February 6, 2005 in Davao City, left two
(2) parcels of land embraced in Transfer Certificate of Title Nos. T-146418
and T-297648 of the Registry of Deeds for Davao City, at the subject of the
Deed of said Extra-judicial Settlement of Estafa with Reconveyance and/or
Waiver and Lifetime Usufruct as per Doc. No. 59; Page 12; Book No. 19;
Series of 2010 of the Notarial Registry of Atty. Jacinto L. Legaspino.
39. That it has been published in the above-mentioned newspaper and can be
verified in the issued of April 18, 25 & May 2, 2011;
IN WITNESS hereof, we have hereunto affixed our signatures this 27 th day of May, 2011
JOSEPHINE I. YU
Affiant
Doc. No. ___________

Page No. ___________
Page No. ___________
Series of 2011.
QUITCLAIM

I, ______, of legal age, single/married, and residing at ______, after having been duly
sworn to according to law, hereby depose and state:
1. That I am an employee of _____, having connected therewith as _____, since
________;
2. That I have a letter of resignation with the company effective ________;
3. That I hereby relieve and discharge said (name of company) and its officers from
any and all claims by way of unpaid wages, separation pay, overtime pay, 13th month pay
or otherwise as may be due me or incident to my employment with said company;
4. That I hereby state further that I have no claim, right or action of whatsoever
nature, whether past, present or contingent, against said company and its officers;
5. That the contents of this document, although prepared in English, was interpreted
and explained to me in Pilipino by the undersigned Personnel Officer and the same is
therefore understood by me;
6. That I am executing this instrument freely and voluntarily without any moral or
physical threat, coercion or promise of reward in any form.
IN WITNESS WHEREOF, I hereby affixed my signature this ___ day of October, 2003
at the City of Makati, Philippines.
Signature of Employee
SIGNED IN THE PRESENCE OF: Signature (Personnel Officer)
Signature (Union Officer)
(ACKNOWLEDGMENT)
RA 9255
R. A. 9255 Form No. 1

(Devised May 2004)
x------------------ / Registry No. _____________
I, ______AMERICUS SOTTO YANONG____, of legal age, Filipino and a resident of Mahogany St.,
Green Meadows Subd., Mintal, Tugbok District, Davao City, Philippines, after having been duly sworn to in

____________ LOVELY ANN SALAS GECONCILLO______ who is my ________daughter_________;
2. She was born on ___ 23 July 2000 __ at ______________ DAVAO CTIY_______________________
3. The birth was recorded under Registry No. _____2003-02837______________ on __ August 4, 2000__;
5. The surname to be change is from ______GECONCILLO___________ to _______YANONG_________
a) __________________________________________________________________________________
b) __________________________________________________________________________________
8. I am filing this affidavit at the LCRO of _________________________________________ in accordance

with R. A. 9255 and the implementing rules and regulations;
belief;
10. In truth whereof, I have hereunto affixed my signature this 17 th day of May, 2006 at Davao City,
Philippines.
AMERICUS S. YANONG
Affiant
SUBSCRIBED AND SWORN to before me this 17 th day of May, 2006, in the City of Davao, Philippines and
I further certify that I have personally examined the affiant and I am satisfied that he voluntarily executed and
understood his affidavit.

City of Davao

_________, Reg. No. _____________________.


x-----------------------/ Registry No. _______________
I, ______AMERICUS SOTTO YANONG____, of legal age, Filipino and a resident of Mahogany

St., Green Meadows Subd., Mintal, Tugbok District, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and say that:
1. I am the natural and biological father of LOVELY ANN SALAS GECONCILLO who
was born on 23 July 2000 __ in __ DAVAO CTIY_________________;
2. My child was born out of wedlock and her mother is Rogelia Salas Geconcillo;
the foregoing facts and for whatever legal purpose this may sefve best.
IN WITNESS HEREOF, I have hereunto affixed my signature this 17 th day of May, 2006 at Davao
City, Philippines.
AMERICUS S. YANONG
Affiant

City of Davao

_________, Reg. No. _____________________.
AFFIDAVIT OF NON-REGISTRATION

x--------------------/
Affidavit of Non-Registration
I, JINELYN CONSUEGRA Y MOCANLAY, 17 years of age, Filipino, single and a resident

of Purok 5, 76-A Bucana Sea Wall, Davao City, after having been duly sworn to in accordance
9. That I was born on September 13, 1986;
10. That as such, I am only seventeen (17) years old;
11. That during the registration day, I did not register considering that I am still a
minor;
IN WITNESS WHEREOF, I have hereunto set my hand this 16 th day of June 2004 at the
JINELYN M. CONSUEGRA
Affiant
SUBSCRIBED AND SWORN to before me this 16th day of June, 2004, in the City of
November 18, 2010
The Manager
Lifefoods International Group Trading
846 Atis St., Juna Subd., Matina
Davao City
S i r :
I am tendering my resignation from my position as Logistics

Driver effective this date.
I am grateful for the opportunity and the experience of

serving the company. I cherish the moments I am with the company
but my ailing mother needs my attention and I will be tasked to
supervise our farm.
I hope that with the seven (7) years of service with our
company, I have somehow, in some ways, contributed a little good.
Thank you very much.
Very truly yours,
ALLAN C. YOAG
Times Beach, Matina
Davao City
1. That I am the Corporate Secretary of ______Corporation with office address at

____;
2. That at a duly convened meeting of the Board of Directors held last ______, where
a quorum was present, the following resolutions were unanimously approved, to wit:
"RESOLVED, that the President, Mr. _____, be authorized, as he is hereby
duly authorized, to negotiate for a loan from _____Bank in the amount of P1,000,000.00 to
be secured by the corporation's Cavite property and authorizing him further to sign for
and in behalf of the corporation any and all papers and documents relative thereto."
3. That the foregoing resolutions are true and correct and that it has not been
amended or superseded up to this date.
at the City of Manila, Philippines.
Signature pf Corporate Secretary
(JURAT)
SSS - Request

x--------------------/
A f f i d a v i t
I, WELBURGA EBRANO VDA. DE DELOS SANTOS, of legal age, Filipino and a

resident of Lot 37, Block 13, Phase 4, Yakal St., Green Meadows Subd., Barangay Santo Niño,
Tugbok District, Davao City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and say:
13. That I am an SSS death pensioner since _________________and receiving

pension of ___Php=3,000.00___ every month accruing from the death of my
husband, _____JESUS DELOS SANTOS_____, with SSS No. 09-0067453-
6;
14. That I applied for loan with LANDMOR LENDING, Cebu City (LANDMOR),
last ___March 15, 2006___ using my pension as payment thereof;
15. That my application for the said loan was equivalent to my three year pension
but I received the net amount of TWENTY EIGHT THOUSAND EIGHT
HUNDRED THREE PESOS (Php=46,000.00) only;
16. That when I applied the said loan, LANDMOR required me to sign more than
twenty (20) blank SSS Form DDR-2 or Pensioner’s Data Change Request;
averments, purposely to request the Social Security System (SSS), Cebu
Branch, not acknowledge the DDR-2 Forms and for whatever purpose this
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 14 th day of August, 2006 at
WELBURGA E. DELOS SANTOS

Affiant
SUBSCRIBED AND SWORN to before me this 14th day of August, 2006, in the City of
satisfied that she had voluntarily executed and understood his affidavit.
__________________________________
REVOCATION OF POWER
OF ATTORNEY
Revocation
Of Power Of Attorney
WHEREAS, That I, FERMINA BARRERA VDA. DE GONZALES, of legal age, Filipino, widow
and a resident of Apitong St., Green Meadows Subd., Barangay Sto. Niño, Tugbok District, Davao City, do
hereby REVOKE, ANNUL and MAKE VOID any authority or any documents I have
executed in favor of LANDMOR FINANCIAL SERVICS, INC., with office
address at Sanciangco St., corner Panganiban St., Cebu City, the same documents I have not
executed before any person authorized to administer oath.
IN WITNESS WHEREOF, I have hereunto set my hand this 21 st day of September 2006 at
FERMINA B. GONZALES
Affiant
SSS No. __0927008693__
_____________________________ & _____________________________
Acknowledgment

Davao Ctiy . . . . . . . . . . . . . . . . . . . ) S.S.
X-------------------------/
BEFORE ME , a Notary Public, for and in the City of Davao, Philippines, personally appeared:
Fermina B. Gonzales with Comm. Cert. No. 040606333 issued on January 01, 2006 at Davao City,
known to me and to me known to be the same persons who executed this instrument and acknowledged to
me that the same is her free act and deed.
Doc. No . __________;
Page No.__________;
Book No.__________;
Series of 2006.
AFFIDAVIT OF SUPPORT
x------------------------/
Affidavit/Support
I, LYDIA SARANZA Y ENGRACIA, of legal age, Filipino, married and a resident of DDF Village,
Mandug, Buhangin, Davao City, Philippines, under oath, depose and say that:
40. I am a government employee, a secondary school teacher of the Davao City National
Hugh School, f. Torres St., Davao City;
41. As such, I am a member of Philippine Health Insurance Corporation (Philhealth);
42. My mother, ANUNCIACION ENGRACIA, who is already 78 years old is under my

support and will be undergoing cataract operation; and
to submit the same to the Philhealth for the purpose of availing benefits.
IN WITNESS hereof, we have hereunto affixed our signatures this ___ th day of ________ in the
LYDIA E. SARANZA
Affiant
SUBSCRIBED AND SWORN TO before me this 8 th day of November, 2004, in the City of Davao,
had voluntarily executed and understood the foregoing affidavit..
AFFIDAVIT OF TENANCY

x--------------------/
I, RUDY CAWAYAN, of legal age, Filipino, married and a resident of Dalagdag, Calinan,
Davao City, Davao City, after having been duly sworn to in accordance with law, do hereby
depose and say:
18. That I am the owner of a 45,824 square meter agricultural parcel of land
situated at Dalagdag, Davao City, the same being described in Original
Certificate of Title No. 7609 of the Register of Deeds for Davao City;
19. That I have donated a 1,000 square meter portion of the above-mentioned
landholding;
20. That my property mentioned above has no tenant, the same being personally
administered by the undersigned’s family;
IN WITNESS WHEREOF, I have hereunto set my hand this _______ th of August, 2004 at
RUDY CAWAYAN
Affiant
SUBSCRIBED AND SWORN to before me this _________ th day of August, 2004, in the
am satisfied that he voluntarily executed and understood his affidavit.
x--------------------/
I, RAUL BURGOS BENDIGO, of legal age, Filipino and a resident of Sta. Cruz, Davao del Sur,
Philippines, after having been duly sworn to in accordance with law, do hereby depose and say:
1. That I am the President of AMLO REALTY AND DEVELOPMENT

CORPORATION (ARDC), a corporation duly organized and existing under the laws
of the Philippines, with office address at Poblacion Sta. Cruz, Davao del Sur;
2. That ARDC is the duly registered owner of a parcel of land: Lot 2, Psu-72193 Amd. 2
containing an area of TWENTY THOUSAND (20,000) SQUARE METERS, more
or less, situated at the Barrio of Sinawilan, Sta. Cruz, Davao del Sur;
3. That the said parcel of land is not tenanted and not subject to a leasehold agreement,
the truth of the matter is that the corporation has personal supervision of the said
land;
4. That I am executing this affidavit in behalf of AMLO REALTY AND DEVELOPMENT

CORPORATION (ARDC).
IN WITNESS WHEREOF, I have hereunto set my hand this 22 nd day of November, 2010 at the City
RAUL B. BENDIGO
Affiant
SUBSCRIBED AND SWORN to before me this 22 nd day of November, 2010, in the City of Davao,
AFFIDAVIT OF TURN-OVER

x-----------------/
Affidavit/Turn-over
I, Angel Marie Cain y Buslon, of legal age, Filipino, single

and with address at c/o Sasa Police Station, Km. 10, Sssa, Davao
City, after having been duly sworn to in accordance with law, do
1. That I am a bona fide member of Philippine National,

presently assigned with Sasa Police, Davao City Police
Office. Km. 10, Sasa, this city, with the rank of Police
Officer –2 and designated as WCD investigator;
2. That on or about 10:58 o’clock in the evening of August 8,

2009, while rendering duty at our office P02 Dean C.
Martin the duty Desk/Complaint Officer turn-over to me
the person Reynaldo Gonzales Vismanos an alleged
suspect for the case of Frustrated Parricide in relation to
R. A. 9262 filed against him by his wife Joan Luyao
Vismanos;
3. Out rightly, I took cognizance the case and conduct

investigation and prepared the pertinent papers to
support the complaint of victim Joan Vismanos;
4. Thereafter, suspect Reynaldo Vismanos was referred to

the duty jailer SPO3 Toraba for proper detention after he
was informed of his constitutional rights as mandated by
law;
5. I am executing this affidavit to attest to the truth of the

foregoing facts to the best of my knowledge and belief.
IN WITNESS WHEREOF, I have hereunto set my hand this

th
10 of August, 2009 at the City of Davao, Philippines.
Angel Marie B Cain

(Affiant )
SUBSCRIBED AND SWORN to before me this 10 th of
August, 2009, in the City of Davao, Philippines and I further
certify that I have personally examined the affiant and I am
satisfied that she voluntarily executed and understood her
affidavit.
UM
x------------------------/
Affidavit Of Two Disinterested Persons

Attesting That Fernando Nollora Maceda And Fernando Nollosa
Macida Refers To The Same And Identical Person
We, ALLAN BUENDIA and JOVY RECAIDO, both of legal age, Filipino, married and residents
of Piapi/Quezon Boulevard, Davao City, Philippines, respectively, after having been sworn to in accordance
1. That we are the same and identical persons who caused the execution of this
instrument;
2. That we know personally FERNANDO NOLLORA MACEDA, the son Francisco

Macida and Rosario Nollosa for we were friends for quite a long time here in Davao
City;
3. That in his dealings with the community as well as in the school records, he used
FERNANDO NOLLORA MACEDA instead of FERNANDO NOLLOSA MACIDA
as correctly reflected in the Certificate of Live Birth;
4. That we attest to the facts aforestated and that we declare nonetheless that
FERNANDO NOLLORA MACEDA and FERNANDO NOLLOSA MACIDA who
was born on November 9, 1960 refer to the same and identical person;
AFFIANTS SAYETH NONE.
IN WITNESS hereof, we have hereunto affixed our signatures this 3 rd day of November 3, 2005, in
ALLAN BUENDIA JOVY RECAIDO

Affiant Affiant
SUBSCRIBED AND SWORN TO before me this 3 rd day of November 2005, in the City of Davao,
Philippines, and I HEREBY CERTIFY that I have examined the affiants and that I am satisfied that the
AFFIDAVIT OF UNDERTAKING

x--------------------/
Affidavit of Undertaking
I, _____________, of legal age, Filipino, single and a resident of ____________, Davao

City, after having been duly sworn to in accordance with law, do hereby depose and say:
7. That I am a holder of Professional Driver License with Number

_______________;
8. That on or about __________________, at around ______________ in the

morning, while driving a tricycle, Suzuki Motorcycle with cab bearing Plate
______________, registered under the name of Bonifacio Areglado, along
the subdivision road of Pab-ibig Heights, Buhangin, coming from Ciudad de
Esperanza heading towards the highway, at the downhill portion, when my
driven tricycle accidentally bumped a pedestrian, one _____________;
9. That as a result thereof, the said pedestrian sustained minor injuries which I
together the victim’s uncle conveyed her to the hospital for treatment;
10. That the victim recovered and I have extended all the medical expenses for
her medication;
11. That to date, no complaint regarding the incident has been filed as the same
has been amicably settled;
12. I am I am executing this affidavit to attest to the foregoing facts and to submit
the same to the Land Transportation Office (LTO), Davao City, purposely to
claim my professional driver’s license; and
13. That I hereby undertake to surrender my license should a complaint be filed

against me pertaining to the same vehicular mentioned above.
IN WITNESS WHEREOF, I have hereunto set my hand this _______ st of _________,
2005 at the City of Davao, Philippines.
_____________________
Affiant
SUBSCRIBED AND SWORN to before me this _______st of _________, ________, in

the City of Davao, Philippines and I further certify that I have personally examined the affiant
and I am satisfied that he/she voluntarily executed and understood his affidavit.
AFFIDAVIT OF REQUEST

x------------------------/
Affidavit Of Request
With Undertaking
I, ____________________, of legal age, Filipino, married and a resident of

___________________________, Davao City, Philippines, after having been sworn to in
23. That I am the new owner of a residential house and lot situated at No.
_________________________, Davao City;
24. That to date, the consumer account under DLPC Account No.
______________ and Meter No. _______________ is still under the name of
its previous owner, ______________, hence this affidavit is executed;
25. That I hereby set the Davao Light Power & Company, Inc. (DLPC) free and
faultless and will solely hold myself liable should a conflict arise in the change
of registered ownership in the above-mentioned account number;
and to submit the same to the DLPC to request for the transfer of registered
owner from its previous owner into the undersigned.
IN WITNESS hereof, I have hereunto affixed my signature this ____ th day of

________________, 2009, in the City of Davao, Philippines.
Affiant
SUBSCRIBED AND SWORN TO before me this ____th day of ________________,

2009, in the City of Davao, Philippines, and I HEREBY CERTIFY that I have examined the
affiant and that I am satisfied that the affiant voluntarily executed and understood the foregoing
affidavit.
AFFIDAVIT OF WAIVER

x--------------------/
Affidavit of Waiver
I, JAN-ERIK E. DAHLGREN, of legal age, Swedish national, married and a resident of

Carmelo Homes, Puan, Davao City, after having been duly sworn to in accordance with law, do
14. That I am the husband of GEMMA LAGUE DAHLGREN, a Filipino citizen, who
purchased a parcel of land from ARNOLD E. NAJERA which property is covered by Transfer
Certificate of Title No. T-254792 of the Registry of Deeds for Davao City, Philippines, situated
in the Barrio of Puan, Davao City, and containing an area of One Hundred Fifty (150) Square
Meters, more or less, the sale being evidenced by Deed of Absolute Sale dated
__________________, 2004 denominated as Doc. No. _____; Book No. _________; Page
No. ____________; Seires of 2004 of the notarial registered of Atty. ________________;
15. That the money used in the purchase of the aforementioned parcel of land
exclusively comes from her paraphernal funds and I have not contributed any
to the purchase of the same;
16. That I hereby WAIVE my right, share, participation and interest iin the
aforesaid parcel of land in favor of my wife;
17. That I hereby declare that said property exclusively belongs to my wife,
Gemma Lague Dahlgren;
averments, for whatever legal purpose this may serve and for purposes not
contrary to law.
IN WITNESS WHEREOF, we have hereunto set our hands this ___________________,
July 2004 at the City of Davao, Philippines.
JAN-ERIK E. DAHLGREN
Affiant
SUBSCRIBED AND SWORN to before me this ________________________, in the

am satisfied that he had voluntarily executed and understood their affidavit.
AFFIDAVIT OF WAIVER

x------------------------/
Affidavit/Waiver
We, _______________ and __________________, of legal age, Filipino, single and residents of
________________, Davao City, Philippines, after having been sworn to in accordance with law do hereby
depose and state:
44. That we are the three (3) of the four (4) surviving children of the late GUSTIN AGUJAR
and MERCEDES DOLORITOS who died sometime in January 4, 2001 and November
1997;
45. That during their marital union, the parents have acquired a property, house & lot, at
St. Mary St., Jerome, Agdao, Davao City;
46. That an electrical facility was installed on the said property and the registered name is
that of my father;
47. That our brother, REDEMTOR DOLORITOS AGUJAR, is now residing on the house
left by our father and has no other place to dwell;
48. That as such, we hereby waived our respective rights and interest over the said facility
to our said brother, and hereby grant our consent for him to have the registered
consumer of the DLPC Account for the said facility transferred to his name;
49. That we are executing this affidavit with our own free will, attesting to the truth of the
foregoing facts and to submit the same to the Davao Light Power * Company for the
aforementioned purpose; and
50. That we are setting the DLPC free and faultless and will hold ourselves solely liable
should a conflict arise in the transfer of registered consumer from that of our father to
our brother, Redemtor D. Agujar.
IN WITNESS hereof, we have hereunto affixed our signatures this _____ th day of
Affiant Affiant
Affiant
SUBSCRIBED AND SWORN TO before me this _____ th day of ___________, in the City of Davao,

x------------------------/
Affidavit/Waiver
I, RAMIL MARBAN LIMPO, of legal age, Filipino, separated and a resident of NPC Compound,
Mintal, Davao City, Philippines, under oath, depose and say that:
51. I am the present occupant of Block No. 8, Lot 10 situated at Purok 21,
Manggahan, Bucana, Davao City;
52. I am relinguishing, as I do hereby relinguished all my rights and interest over

the above-mentioned lot unto and in favor of CHARLIE GARCIA ABABA, of
legal age, Filipino, married to Joel Impuerto Ababa and a resident of 76-A Brgy. 21,
bucana, Davao City;
53. I further waive my right to claim against her occupation; and
54. That this affidavit is made in good faith and that I executed this presents
voluntarily, freely, and without mental reservations and with full knowledge of
my rights under the law.
IN WITNESS hereof, we have hereunto affixed our signatures this 13 th day of October,
_________________________
Affiant
SUBSCRIBED AND SWORN to before me this 25 th day of November, 2004, in the City of Davao,
We, AMERICUS S. YANONG and GLORIA R. VILLA-ABRILLE, both of legal age,
Filipino, married and residents of Green Meadows Subd., Brgy. Sto. Niño, Tugbok District,
Davao City, Philippines, respectively, after having been sworn to in accordance with law do

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REPUBLIC OF THE PHILIPPINES )

In The City of Davao )ss

Joint Affidavit Of Discrepancy

We, GRACE C. FERNANDEZ and CECILE S. ENCOMIENDA, both of legal age,

GRACE S. FERNANDEZ CECILE C. ENCOMIENDA

I, JEANELYN ROSALYN ARCENA, of legal age, Filipino, married and a resident of

1. That I am the aunt of JERRICHO ROSALYN ARCENA;

Doc No. _________

1. That I am a holder of a PROMO COUPON of BANDERA SING-

2. That fortunately, on January 26, 2016 I received a message thru

3. That however, my said coupon was misplaced in my place of

4. That it is my intent to claim my winnings, hence, this affidavit;

5. That I am executing this affidavit to attest to the truth of the

IN WITNESS hereof, I have hereunto affixed my signature this

MERRY CHRISTINE C. ABSALON

SUBSCRIBED AND SWORN to before me this _________________ in the

Joint Affidavit Of Discrepancy

7. We personally know the persons of ALMA LAHIRA ALBARRACIN and MARY

ARLENE CADAVEZ CECILE COSTAN

SUBSCRIBED AND SWORN to before me this ____________________ in the City of Davao,

6. That at about 7:00 o’clock in the evening of February 18, 2016, I

7. That I saw Roldan busy doing some electrical job/wirings at his

8. That while thereat, a skin-head motorcycle riding man arrived

12. That I am executing this affidavit to attest to the truth of the

IN WITNESS hereof, I have hereunto affixed my signature this

SUBSCRIBED AND SWORN to before me this _________________ in the

REPUBLIC OF THE PHILIPPINES )

13. That I am the common-law wife of CPL ALENENOGENES G.

14. That my said husband died in action on May 23, 2015 in

15. That being a child of an enlisted personnel, my son is entitled to

17. That I am executing this affidavit to attest to the truth of the

IN WITNESS hereof, I have hereunto affixed my signature this

MARY JOY M. MAGBUTONG

SUBSCRIBED AND SWORN to before me this _________________ in the

REPUBLIC OF THE PHILIPPINES )

18. That I am a holder of Non-Professional Driver License No. LO5-

19. That unfortunately, for over-speeding last Friday afternoon, my

20. That as such, I was issued Temporary Operator’s Permit.

22. That I have reported the loss of my license at Police Station 3,

24. That I am executing this affidavit to attest to the truth of the

IN WITNESS hereof, I have hereunto affixed my signature this

SUBSCRIBED AND SWORN to before me this _________________ in the

REPUBLIC OF THE PHILIPPINES )

Joint Affidavit Of Discrepancy

IN WITNESS HEREOF, we have hereunto affixed our signatures this

ARLENE CADAVEZ CECILE COSTAN

SUBSCRIBED AND SWORN to before me this ____________________ in the City of Davao,

REPUBLIC OF THE PHILIPPINES )

Joint Affidavit Of Discrepancy

RICHARD S. FLORIDA HERMINIA B. SIBUNGA

SUBSCRIBED AND SWORN to before me this ____________________ in the City of Davao,

REPUBLIC OF THE PHILIPPINES )

IN WITNESS HEREOF, we have hereunto affixed our signatures this

SUBSCRIBED AND SWORN to before me this ____________________ in the City of Davao,

REPUBLIC OF THE PHILIPPINES )

1. That I am the eldest of the two (2) children of LUCRECIO POLINAR

IN WITNESS HEREOF, we have hereunto affixed our signatures this

SUBSCRIBED AND SWORN to before me this ____________________ in the City of Davao,

REPUBLIC OF THE PHILIPPINES )

5. That I am the eldest of the two (2) children of LUCRECIO POLINAR

IN WITNESS HEREOF, we have hereunto affixed our signatures this

REPUBLIC OF THE PHILIPPINES )