Republic of the Philippines )

Province of Lanao del Norte) S.S.

Municipality of Kolambugan)

AFFIDAVIT

I, Genevieve Cardona, of legal age, Filipino, single, with residence and postal
address at Poblacion, Kolambugan, Lanao del Norte, after having been sworn to an oath
in accordance with law, depose and say:

That I am an applicant in Miscellanepous Sales Application No. 123508-3

covering Lot No. 6252, Ts-210 situated in Poblacion, Kolambugan with an area of Two
Hundred Eighty Three (283) square meters, more or less;

That my application is now under processed at the Land Management Sector,

CENRO Kolambugan, Lanao del Norte;

That as part of its mandate , the said Office appraised my lot as basis for the
payment of the purchase cost;

That I cannot afford to pay for the purchase cost of my lot;

That by virtue of this Affidavit, I hereby request CENRO Kolambugan through

the CENR Officer to convert my Miscellaneous Sales Application No. 123508-3 covering
the aforementioned lot to Residential Free Patent ;

That I further waive in favor of the government whatever payments I have made
appertaining to my Miscellaneous Sales Application.

That I am executing this Affidavit feely and voluntarily to attest to the foregoing
facts and to support the Residential Free Patent Application that I will file with CENRO
Kolambugan over lot 6252, Ts-210

IN WITNESSWHEREOF, I have hereunto affix my signature this 29th day of

September, 2010 at Kolambugan, Lanao del Norte.

GENEVIEVE CARDONA
Affiant
CTC No. ______________
Issued on ______________
Issued at _______________

SUBSCRIBED AND SWORN to before me on the date and place above

specified.

ALICIA H. GEMENTIZA
Special Investigator 1