Republic of the Philippines }

City Of Davao }
x-------------------------------------/

AFFIDAVIT

I, ________________, of legal age, Filipino, married and a resident of ___________

____________, Davao City, Philippines hereby depose and say, THAT:

1. On June 28, 2007, I executed an extrajudicial partition of estate;

2. On the said instrument, I stated under oath that I am married without however,
mentioning the name of my spouse;

3. I am stating for a fact that the name of my spouse is __________.;

4. I have attached herewith our marriage certificate marked as Annex “A” hereof;

5. Upon the execution of the Extrajudicial Partition of Estate, my spouse did not affix his
signature since the property subject of the instrument is my inheritance from my parents
and does not include conjugal property;

6. I am executing this instrument to attest the truthfulness and correctness of the above
stated facts to the best of my personal knowledge;

IN WITNESS WHEREOF, I have hereunto set my hand this ____________________ at

Davao City, Philippines.

____________________________
Affiant

SUBSCRIBED AND SWORN to before me this ______________________ at Davao

City, Philippines. Affiant exhibited to me her _______________ with identification Card
Number ______________.

________________________________
Notary Public
Until December 31, 2008
LAW OFFICES
, Davao City
PTR No.70 01-02-08
IBP O.R. No. 11 01-02-08
Doc. No.:__________ TIN ____________Roll No. _________
age No.:__________
Book No.:_________
Series of 2008.