REPUBLIC OF THE PHILIPPINES)

PROVINCE OF PANGASINAN ) S.S.

MUNICIPALITY OF MANGALDAN)

AFFIDAVIT OF REQUEST FOR RE-CLASSIFICATION

I, MARCOS L. AQUINO, of legal age, Filipino and a resident of Brgy. Anolid,

Mangaldan, Pangasinan after being duly sworn to in accordance with law, hereby
depose and state:

1. That I am the owner of a parcel of land located at Brgy. Anolid, Mangaldan,

Pangasinan, covered by Tax Declaration No. 00436612;

2. That the above described property is classified as “unirrigated rice land” as per
declaration no. 00436612;

3. That I am tend to use the above described property as a residential lot for the
benefit of my family;

4. That I hereby request that my property be converted from “unirrigated rice

land” to ”RESIDENTIAL LAND or LOT”;

5. That I am executing this Affidavit to attest to the truthfulness of the foregoing

facts and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this February

11, 2020 in Mangaldan, Pangasinan.

MARCOS L. AQUINO
Affiant
OCSA ID NO. 0668
Anolid, Mangaldan, Pangasinan

SUBSCRIBED AND SWORN to before me this ___________________ in

Mangaldan, Pangasinan.

ATTY. FERNANDO JUAN A. CABRERA

Doc. No. _________ NOTARY PUBLIC
Page No. _________ UNTIL DECEMBER 31, 2021
Book No._________ YDIA ST. BRGY. GUILIG, MANGALDAN, PANG.
Series of 2020. IBP No. 1058/12-4-19
PTR No. 4232102/1-2-2020
ROLL NO. 62453/TIN 429-314-607-000
SNC-NP-15-2020
MCLE Comp. No. VI-0008445, 5-9-18