Accident Halo

REPUBLIC OF THE PHILIPPINES)
CITY OF MARIKINA………….....) S.S
AFFIDAVIT
I, EDWARD VINCENT R. CHENG, of legal age, Filipino citizen and a resident of No.
27 Maranaw Street, La Vista, Quezon City, after having been duly sworn to in accordance with
law depose and say:
1. That I am the registered and lawful owner of MISS TWIST (kiosk), with business
address at No. 49 Chestnut New Marikina , San Roque, Marikina City;
2. That said business on November 12, 2020, the whole village/subdivision was flooded
with water and mud due to heavy rain caused by typhoon “Ulysses”;
3. That due to said incidence, the said business were flooded particularly the (e.g. original
copy of Official Receipts, Stock, et. al.);
4. That therefore, I desire to cancel the afore-cited business due to I am no longer

interested;
5. That I am executing this affidavit to attest to the truth of the foregoing facts to inform the
government offices pertaining for the said cancellation of business name and for
whatever legal intents it may serve.
FURTHER I SAYETH NAUGHT.
EDWARD VINCENT R. CHENG
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this _________________________

at Marikina City, by EDWARD VINCENT R. CHENG, who has satisfactorily proven his
competent evidence of identity through his ______________________________, that he is the
same person who personally signed before me the foregoing Affidavit and acknowledged that he
executed the same.
Doc. No. :
Page No. :
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CITY OF MARIKINA………….......) S.S
AFFIDAVIT OF OWNERSHIP
I, ZANZIBAR GUANZON MISAJON, of legal age, Filipino citizen and a resident of

Ponlacion 2, Hamtic Antique, after having been duly sworn to in accordance with law hereby
depose and say:
1. That I am the rightful and lawful owner of one (1) unit of motorcycle, as per Deed of
Sale of Motor Vehicle, described as follows:
Make : KTM
Model : KTM 450 SXF 2018
Chassis No. : VBKSXE437JM326125
Motor No. : 7943620000R
2. That in my capacity as rightful owner, I hereby unconditionally warrant the absolute

ownership of the above-described of one (1) unit of motorcycle;
3. That I hereby undertake to defend such of one (1) unit of motorcycle, as well as
assume, and satisfy any suits or claims resulting there from, without cost, charge or
liability whatsoever;
4. That I am executing this affidavit to attest to the truth of the foregoing facts, to
warrant the ownership of the above-described of one (1) unit of motorcycle and for
whatever legal intents and purposes this may serve.
ZANZIBAR GUANZON MISAJON

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ___________________________

at Marikina City, by ZANZIBAR GUANZON MISAJON who has satisfactorily proven his
competent evidence of identity through his DL#F08-07-001557, that he is the same person who
personally signed before the foregoing Affidavit and acknowledged that he executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2020.
MARIKINA CITY……….…………...) S.S
AFFIDAVIT OF NO EMPLOYEE & NO ALPHALIST OF PAYEE
I, EMELYN BELDUA REGALARIO, of legal age, Filipino citizen and a resident of No. 06
Acapulco Street, Serra Monte Mansions Filinvest East Homes, Brgy. San Isidro, Cainta, Rizal,
after having been duly sworn to in accordance with the law, do hereby deposes and state;
1. That I am the co-owner of a business known as “RAGALARA BAKE HOUSE

COMPANY” with office and business address at No. 06 Acapulco Street, Serra
Monte Mansions Filinvest East Homes, Brgy. San Isidro, Cainta, Rizal;
2. That said “RAGALARA BAKE HOUSE COMPANY” is a partnership business;
3. That my partner and I are the ones who manage and operate the said business
that’s why we don’t have any employees as well as no alpha list of payee;
4. That this Affidavit is executed to attest to the truth of the foregoing statements for all
purposes it may legally serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 15th day of

October, 2020 at Marikina City.
EMELYN BELDUA REGALARIO

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 15th day of October, 2020 at

Marikina City, by EMELYN BELDUA REGALARIO, who has satisfactorily proven her
competent evidence of identity through her Company ID # 003, that she is the same person who
personally signed before me the foregoing Sworn Statement and acknowledged that she
executed the same.
Doc. No. 391 :

Page No. 71 :
Book No. 40 :
Series of 2020.
MARIKINA CITY……….…………...) S.S
SWORN STATEMENT
I, YOLADA DIZON BATARA, of legal age, Filipino citizen, with postal address at No. 47 A.
Flores Street, Jesus Dela Peña, Marikina City, after having been duly sworn to in accordance with
the law, do hereby deposes and state;
5. That I am the duly elected Secretary of the ART WEDNESDAY Art Group with office
address at No. 7 Bocobo Street, Xavierville 1 Subd. Loyola Heights, Quezon City;
6. That I hereby affirm that none of the organizers, directors or official of our said
organization is an agent of or related by consanguinity or affinity up to the forth civil
degree to the officials or any Executive Council Members of the NCAA;
7. That this Affidavit is executed to attest to the truth of the foregoing statements for all
purposes it may legally serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 21st day of September,
2020 at Marikina City.
YOLADA DIZON BATARA

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 21st day of September, 2020 at

Marikina City, by YOLADA DIZON BATARA who has satisfactorily proven her competent evidence
of identity through her Driver’s License No. N04-07-016258, that she is the same person who
personally signed before me the foregoing Sworn Statement and acknowledged that she executed
the same.
Doc. No. 222 :

Page No. 45 :
Book No. 37 :
Series of 2020.
CITY OF MARIKINA…………….... ) S.S.
AFFIDAVIT OF INCOME
I, JENELYN DANDAN CORDOVA, of legal age, Filipino citizen and a resident of No. 379 Bagong
Silang Street, Nangka, Marikina City, after having been duly sworn to in accordance with law hereby
depose and say:
1. That I am the mother of Krisha Mhae Dandan Cordova;
2. That my daughter intend to apply and enroll for Grade XI;
3. That I am received a monthly remittance from my father-in-law amounting of Php4,000.00 per

month;
4. That therefore, I have an income to be declared;
5. That I am executing this affidavit to attest to the truth of the foregoing facts to comply the
necessary requirements for her Educational Assistance and for whatever legal intents and
purpose this may serve.
JENELYN DANDAN CORDOVA

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 02nd day of July, 2020 at Marikina
City, by JENELYN TUMBAGA DANDAN who has satisfactorily proven her competent evidence of identity
through her Police Clearance Card No. SMR0763094, that she is the same person who personally signed
before me the foregoing Affidavit and acknowledged that she executed the same.
Doc. No. 238 :

Page No. 48 :
Book No. 28 :
Series of 2020.
AFFIDAVIT OF INCOME
I, EDGAR LORETO IMPERIAL, of legal age, Filipino citizen and a resident of Block 10 Lot 7
Karayom Street, San Roque, Marikina City, after having been duly sworn to in accordance with law hereby
depose and say:
1. I regularly receive professional/talent service fee or earn an income as Php13,962.00;
2. As such, I have a gross income of Php35,000.00 for the last six (6) months and to prove that I
have the capacity to pay a Short-Term-Loan (STL) which I intend to avail from the fund;
3. That I am executing this Affidavit of Income in support of my Short-Term Loan application from
the Pag-IBIG Fund, and for whatever legal purpose it may serve.
EDGAR LORETO IMPERIAL

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 07th day of December, 2020 at

Marikina City, by EDGAR LORETO IMPERIAL, who has satisfactorily proven his competent evidence of
identity through his UMID CRN-0111-9065366-7, that he is the same person who personally signed before
me the foregoing Affidavit and acknowledged that he executed the same.
ATTY. MA. ELENA T. MARALLAG-CAJUCOM

Notary Public
Doc. No. 18 : Until December 31, 2020
Appointment No. 20 (2019-2020)
Page No. 04 : PTR No. MKT8116089/01-02-2020/Marikina City
Book No. 48 : IBP Lifetime Member No. 014749/05-26-2016/Cagayan
Roll. No. 52831
Series of 2020. MCLE VI 0028635 valid until 04-14-2022
No. 6 Mariano Arcade, Gunting Street,
Midtown San Roque, Marikina City
Tel. No. 8631-25-60
MARIKINA CITY………………..….) S.S
AFFIDAVIT OF NO TITLE
I, JOSEPHINE BERNADAS ANGCANAN, of legal age, Filipino citizen and a resident of 4245
ME Bayas CPD, Street Bayas CPD Halang, Amadeo 4120 Cavite, after having been duly sworn
to in accordance with the law, do hereby deposes and state:
1. That I am one of the surviving heirs of the late Spouses Ernesto A. Bernandas &
Bibiana J. Bernadas, owners of the certain property situated at the Brgy. Fortuna,
Municipality of Floridablanca, Province of Pampanga, containing an area of 135
square meters and embraced by Tax Declaration No. PSP-050011-01293 and PIN
No. 019-05-0011-020-17;
2. That the above-described property has no Transfer Certificate of Title, it was only
Tax Declaration;
3. That I have executed this Affidavit to attest to the truth and veracity of all the
foregoing facts and for all legal intents and legitimate purpose this may serve.
IN WITNESS WHEREOF, the party signed this instrument, this ________________ at

Marikina City.
JOSEPHINE BERNADAS ANGCANAN

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ______________ at Marikina City,

by JOSEPHINE BERNADAS ANGCANAN who has satisfactorily proven her competent
evidence of identity through her DL # D18-02-019802, that she is the same person who
personally signed before me the foregoing Affidavit and acknowledged that sheexecuted the
same.
Doc. No. :
Page No. :
Book No. :
Series of 2020.
MARIKINA CITY…………………...) S.S
AFFIDAVIT OF EXPLANATION
I, MARA HUTEA SEVERO, of legal age, Indian citizen and a resident of No. 33 B
Tindalo Street Town & Country, Antipolo City, after having been duly sworn to in accordance
with the law, do hereby deposes and state:
1. That I am the father of VARDAN SINGH BRAR, born on July 24, 2018 in Antipolo
City;
2. That the mother of my son is Veerpal Kaur Gill, also an Indian citizen;
3. That the petition of the correction of middle name of my son on his birth certificate is
ongoing process before the Office of the Civil Registrar in Antipolo City under
Petition No. CCE-00629-2018;
4. That the traditional of the Republic of India, all men are using SINGH stands that
your identity is a male/boy while KAUR used for all girls and stands for as female
identity;
5. That in the case of my petition of my son, I want to used SINGH as his middle name
of my son not GILL which is the mother’s last name, due to our tradition and religious
in our country to determined whether you are a boy and a girl;
6. That my son known as VARDAN SINGH BRAR not VARDAN GILL BRAR;
foregoing statements in order to comply with the requirement and for all legal intents
and legitimate purposes this may serve.
IN WITNESS WHEREOF, we have hereunto affixed our signature, this ______________

in Marikina City.
GURMOHAN SINGH BRAR

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this __________________________

at Marikina City, by GURMOHAN SINGH BRAR who has satisfactorily proven his competent
evidence of identity through his Driver’s License # N26-10-005479, that he is the same person
who personally signed before me the foregoing Affidavit and acknowledged that he executed
the same.
ATTY. ANNA THERESA C. CRUZ
Notary Public
Until December 31, 2019
Doc. No. 368 : PTR No. 7244231 / 01-03-2018 / Marikina City
IBP No. 019109 / 12-20-2017 /RSM
Page No. 74 : Roll. No. 52694
Book No. 184-b : MCLE V – 0022100 / 04-14-2019
Series of 2019. No. 6 Mariano Arcade, Gunting Street,
Tel. No. 736-1168 / 736-11-69
MARIKINA CITY………………….) S.S
I, ANNE YOCHABEL L. NAMOCATCAT, of legal age, Filipino citizen and presently at

No. 74 Senegal Street, Nangka, Marikina City, after having been duly sworn to in accordance
1. That I am a professional Real Estate Agent with registered TIN No. 313-176-638-000
under OCN # 3RC00787620 dated 01-19-2013;
2. That I don’t have an Income Tax Return before, I was registered as professional to
the Bureau of Internal Revenue and it is started my profession on 01-19-2013 as
Contract basis only;
3. That I decided to cancel the Certificate of Registration as my profession to the office

of Bureau of Internal Revenue due to I am no longer interested;
4. That I was settled and pay all the corresponding penalties for the year 2017 & 2018
of being no Income Tax Return at all;
5. That one of the requirements for the closure of my profession is the submission of
Income Tax Return. Unfortunately, I failed to comply due to the present that I don’t
have yet an Income Tax Return;
foregoing statements in order to comply with the requirement and for all legal intents
and legitimate purpose this may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature, this _______________

in Marikina City.
ANNE YOCHABEL L. NAMOCATCAT

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this __________________________ at

Marikina City, by ANNE YOCHABEL L. NAMOCATCAT who has satisfactorily proven her
competent evidence of identity through her TIN # 313-176-638-000, that she is the same person
who personally signed before me the foregoing Affidavit and acknowledged that she executed
the same.
Notary Public
Page No. 40 : IBP No. 019109 / 12-20-2017 /RSM
Book No. 187-B : Roll. No. 52694
Series of 2019. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69
MARIKINA CITY……………...........) S.S
AFFIDAVIT
I, NANDY A. PABLO JR., of legal age, Filipino citizen and a resident of No. 2B 201 MRH Bldg.
Kaginhawaan Street, Karangalan Village, Manggahan, Pasig City, after having been duly sworn to in
accordance with the law, do hereby deposes and state;
1. I am a bonafide member of the Social Security System (SSS) with assigned SSS Number
0033-4870038-6;
2. I was an employee of UNITED PHILIPPINE LINES INC. with office address at UPL Bldg. Sta.
Clara Street, Inramuros, Manila from December 05, 2005 to February 18, 2020;
3. I was terminated from employment effective February 18, 2020 due to Economic down turn;
4. I cannot secure a Notice of Termination from my employer; and
5. That I am executing this affidavit to attest to the truth and veracity of the foregoing statements
and to support my application for unemployment insurance or involuntary separation benefit.
IN WITNESS WHEREOF, I hereby set my hand and affix my signature this 28 th day of December,
2020 at Marikina City.
NANDY A. PABLO JR.

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 28th day of December, 2020 at Marikina City,
by NANDY A. PABLO JR. who has satisfactorily proven his competent evidence of identity through his Pag-
Ibig MID#1050-0255-6689, that he is the same person who personally signed before me the foregoing
Affidavit and acknowledged that he executed the same.
Doc. No. 449 :

Page No. 90 :
Book No. 50 :
Series of 2020.
AFFIDAVIT
We, ANGELINE SAN DIEGO SY LEE YONG and MICHELLE SAN DIEGO SY LEE
YONG, both of legal age, Filipino citizens and residents of Block 27 Lot 10 Turquoise Street
Cainta Green Park Village, Cainta Rizal, after having been duly sworn to in accordance with the
law, do hereby deposes and state:
4. That we are the daughters and surviving heirs of the late MARCELO O. SY LEE
YONG, died on March 20, 2019 in San Jose Del Monte, Bulacan;
5. That the deceased is a payee in Globe Telecommunication under Metrobank

Savings Account No. 004-3-73486798-6;
6. That as the surviving heirs, we are requesting Globe Telecommunication to consider

us payee in the said account and change the account number from existing Account
No. 004-3-73486798-6 to its new Banco De Oro Savings Account No.
000440407788 SM Mega A Branch;
7. That we had executed this Affidavit to attest to the truth and veracity of all the
IN WITNESS WHEREOF, the parties signed this instrument, this ________________

at Marikina City.
ANGELINE SAN DIEGO SY LEE YONG MICHELLE SAN DIEGO SY LEE YONG
Affiant Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 28th day of March 2019 at Marikina
City, by ANGELINE SAN DIEGO SY LEE YONG and MICHELLE SAN DIEGO SY LEE
YONG who has satisfactorily proven their competent evidence of identity through their UMID #
0033-9838428-6 & SSS # 33-7307756-3, that they are the same person who personally signed
before me the foregoing Affidavit and acknowledged that they executed the same.

Notary Public
PTR No. 7799121 / 01-03-2019 / Marikina City
Doc. No. 231 : IBP No. 063029 / 01-03-2019/RSM
Book No. 202 : MCLE V – 0022100 / 04-14-2019
Series of 2019.
Tel. No. 736-1168 / 736-11-69
AFFIDAVIT
I, FELY CHUA, of legal age, Chinese citizen and a resident of No. 518 Nueva Street
Binondo, Manila, after having been duly sworn to in accordance with the law, do hereby deposes
and state:
1. That I was born on September 26, 1953 in Manila;
2. That I am the cardholder and registered owner of an ICARD with No. F0000033843
expires on 12-22-2016 issued by Bureau of Immigration;
3. That I intend to renew my ICARD from Bureau of Immigration and one of the
requirements is the submission of Passport;
4. That I never been issued a Passport nor travel outside of the Philippines;
foregoing for all legal intents and legitimate purpose this may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature, this

_______________ in Marikina City.
FELY CHUA
Affiant

at Marikina City, by FELY CHUA who has satisfactorily proven her competent evidence of
identity through her ICARD No. F0000033843, that she is the same person who personally
signed before me the foregoing Affidavit and acknowledged that she executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2016.
MARIKINA CITY…………..………..) S.S.
AFFIDAVIT OF MINIMAL INCOME
I, ARSENIO O. UNGRIANO, of legal age, Filipino citizen and a resident of No. 280 Ilang-Ilang
Street, Greenheights Newtown Subdivision, Mayamot, Antipolo City, after having been duly sworn to in
accordance with the law, do hereby deposes and state:
1. That I and my spouse Lily Fe Ungriano are the defendants of our business, SYDIONG ENTERPRISE
CO and CHAYA MARKETING filed against the complainant under docketed as Civil Case No. 2018-
1874 MK dated 11-15-2018 known Sum of Money w/ Prayer for Preliminary Attachment before the
Regional Trial Court (RTC) Branch 272 Marikina City;
2. That our business rendered services as an agent for different styles of slippers to our valued
client/s which I received income with an average of Php15,000.000 per month. That sometimes
I have no clients, therefore I have a minimal income;
3. That I have no capacity to get an private lawyer to defend and represent us in the said case
because I am an ordinary people;
4. That I have executed this Affidavit to attest to the truth and veracity of all the foregoing for all
legal intents and legitimate purpose this may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature, this _______________ in Marikina

City.
ARSENIO O. UNGRIANO
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this __________________________at Marikina City, by

ARSENIO O. UNGRIANO who has satisfactorily proven his competent evidence of identity through his Driver’s
License # N04-94-321532, that he is the same person who personally signed before me the foregoing Affidavit and
acknowledged that he executed the same.
Doc. No. 269 :

Page No. 54 :
Book No. 208 :
Series of 2019.
DEED OF AFFIRMATION
KNOW ALL MEN BY THESE PRESENTS:
This Deed of Affirmation is made and executed into by and between:
SPOUSES RICARDO CLARIVALL and VENUS CLARIVALL, both of legal age, Filipino
citizens and residents of No. 7 Martin Street Samsonville Subdivision, Marcos Highway, Mayamot,
Antipolo City, hereinafter referred to as the SELLERS;
-And-
SPOUSES EDUARDO ENCARNADO and HELEN ENCARNADO, both of legal age,

married to JENNIFER S. BAMBA, Filipino citizens and residents of Lot 3 Block 1 Phase II Tres
Hermanos Village, Mayamot, Antipolo, Rizal, hereinafter referred to as the BUYERS;
WITNESSETH: THAT
1. That on August 26, 1998 herein parties executed a Deed of Absolute Sale over a certain one
(1) parcel of land located at Tres Hermanas Village, Cupang, Antipolo City covered by
Transfer Certificate of Title No. N-84865 and docketed as Doc. No. 140; Page No. 29; Series
of 1998 and duly notarized by Atty. Raul Cruz Olpindo, Notary Public for and in Marikina City
which is hereby being incorporated as part hereof.
2. That the original of the Deed of Absolute Sale dated August 26, 1998, can no longer be
found despite diligent efforts to locate the same which was filed an Affidavit of Loss dated
December 6, 1998 to the office of the Clerk of Court of RTC Marikina City.
3. That the both parties agreed to executed into Deed of Affirmation to affirm and reiterate the
sale of the vacant lot covered by TCT No. N-84865 located at Tres Hermanas Village,
Cupang, Antipolo City, by Spouses Ricardo Clarivall and Venus Clarivall as the SELLERS in
favor Spouses Eduardo Encarnado and Helen Encarnado, as BUYERS.
4. That the above-named parties affirmed and confirmed that there was an actual and real
Deed of Absolute Sale done and executed dated on August 26, 1998.
5. That the newly executed Deed of Affirmation is intended to serve as a substitute to the lost
original of the Deed of Absolute Sale dated August 26, 1998 for the re-issuance of the
pertinent Certificate of Authorizing Registration (CAR) from the Bureau of Internal Revenue
and the issuance of the corresponding land title.
IN WITNESS WHEREOF, we have hereunto set our hands this _______________________ at

Marikina City
RICARDO CLARIVALL EDUARDO ENCARNADO

SELLER BUYER
VENUS CLARIVALL HELEN ENCARNADO

SELLER BUYER
SIGNED IN THE PRESENCE OF:
_______________________________ ________________________________
Witness Witness
ACKNOWLEDGEMENT

I certify that on this date, before me, a notary public duly authorized in the city named above
to take acknowledgments, personally appeared:
NAME Proof of Identity

RICARDO CLARIVALL
VENUS CLARIVALL
EDUARDO ENCARNADO
HELEN ENCARNADO
who were identified by me through competent evidence of identity to the same person described in
the foregoing instrument, who acknowledged before me that their respective signatures on the
instrument, were voluntarily affixed by them for the purposes stated therein, and who declared to me
that they have executed the instrument as their free and voluntary act and deed.
This instrument consisting of two (2) pages, where the parties and their instrumental
witnesses signed on each and every page thereof, refers to a Deed of Affirmation.
WITNESS MY HAND AND SEAL on the date and place first above-written.
Doc No. :
Page No. :
Book No. :
Series of 2019.
AFFIDAVIT
I, GERARDO C. CRUZ JR., of legal age, Filipino citizen and a resident of No. 15
Narcissus Street Greenpark Village, Cainta Rizal, after having been duly sworn to in accordance
1. That I am the uncle of Lester Alonzo Balisacan;
2. That the mother of my nephew is Liza L. Alonzo;
3. That he was studied at Technological Institute of the Philippines (TIP), Quezon City
in the field of BSIT for the school year 2014-2015;
4. That he stopped schooling year 2015 up the present due to desire to change his course
as BSHRM and he want to transfer at San Sebastian-Recoletos;
foregoing statements in order to comply with the requirements and for all legal intents

GERARDO C. CRUZ JR.

Affiant
SUBSCRIBED AND SWORN to before me this _________________________ at

Marikina City. Affiant exhibited to me his Non-Professional Driver’s License No. D16-08-
002016 expires on 06-04-2016 issued at LTO, Quezon City.
Doc. No. 100 :

Page No. 20 :
Book No. 86 :
Series of 2016.
I, JONA P. BALITAYO, of legal age, Filipino citizen and a resident of No. 12 Michael
Street Kingsville Subdivision, Antipolo City, after having been duly sworn to in accordance with
the law, do hereby deposes and state:
1. That around 04:45 in the morning on this date of June 08, 2016, my car has park in
the garage inside our village at Kingsville Subdivision, Antipolo City and I left my
bag inside the car which containing necessary valuable things and Cards such as
Unified Multi-Purpose ID, Driver’s License, Phil-health ID, ATM Cards (BPI, PS
Bank, PNP), Samsung Mobile Phone, I-touch, Check book, laptop and other
necessary documents;
2. That a few minutes after, I decided to get my bag inside the car and I found out that
my bag was stolen an unidentified suspect and nowhere to be found;
3. That due to said incidence, I immediately report at our office known as ATLASSIAN
PHIL., with postal address at 2nd Floor B3 Bonifacio High Street, Bonifacio Global
City, Taguig City;
4. That I also report at the security guard of our subdivision regarding the incident, after
few of hours, one of the security guard in our village caught the suspect holding the
subject stolen bag. The suspect pleaded not to file a case against him then I decided
not to complain in exchange to return my bag complete, nothing was missing.
Further, no Police Report has made;
5. That therefore, I recover my bag already including all my Cards, gadgets and other
valuables things;
foregoing statements in order to inform at ATLASSIAN PHIL. and for all legal
intents and legitimate purpose this may serve.

JONA P. BALITAYO
Affiant

at Marikina City, by JONA P. BALITAYO who has satisfactorily proven her competent
evidence of identity through her Driver’s License # N02-15-002769, that she is the same person
the same.
Doc. No. 168 :

Page No. 34 :
Book No. 96 :
Series of 2016.

MARIKINA CITY………………..… ) S.S
AFFIDAVIT
I, JEZRON RAFAEL U. BRASILEÑO, of legal age, Filipino citizen and a resident of No.
10 Mangosteen Street Town & Country Executive Village, Antipolo City, after having been duly
sworn to in accordance with the law, do hereby deposes and state:
1. That I am formerly graduated at College of San Benildo-Rizal of Grade 12 for the

year 2018;
2. That I intend to enroll and study to Polytechnic University of the Philippines;
3. That I never been enrolled into any private and government school nor TESDA
after graduation;
foregoing facts with regards for my application and for all legal intents and legitimate
AFFIANT I SAYETH NAUGHT.
JEZRON RAFAEL U. BRASILEÑO

Affiant

Marikina City, by JEZRON RAFAEL U. BRASILEÑO who has satisfactorily proven his
competent evidence of identity through his School ID # 2012-11613, that he is the same person
the same.
Notary Public
Doc. No. 217 : IBP No. 019109 / 12-20-2017 /RSM
Book No. 169-b : MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69
`
AFFIDAVIT
I, MANNY M. JOVES, of legal age, Filipino citizen and a resident of Block 41 Lot 04
Purok I, Brgy. Lawang Pare, Bulacan, after having been duly sworn to in accordance with the
1. That I am the Proprietress and registered owner of ANGEL’S FASHION STUDIO

with office address Annex 3 D & L Building, 2214 Legarda Street, Sampaloc, 042,
Brgy. 416, Manila;
2. That I am the only one who manage and operating in the said business that’s why I
don’t have any employees;
3. That I did not submit any remittance of membership to the office of Home
Development Mutual Fund because no employees at all;
MIA THERESE U. ARIAS

Affiant

Marikina City, by MIA THERESE U. ARIAS who has satisfactorily proven her competent
evidence of identity through her UMID # 0111-4686357-9, that she is the same person who
personally signed before me the foregoing Affidavit and acknowledged that she executed the
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.
MARIKINA CITY………………....) S.S
AFFIDAVIT
I, HARJINDER SINGH SIDHU BRAR, of legal age, Indian citizen and a resident of
No. 37 Tindalo Street Town & Country Executive Village, Antipolo City, after having been duly
1. That I am a holder of Indian Passport No. H7861028 issued on 10-19-2009 expires

on 10-18-2019 issued by Republic of India;
2. That I have clean cut hygiene on my personal appearance which appeared in my

Indian Passport and I don’t have a beard before;
3. That since then and up to the present, I decided not to cut my beard all over my face,
that’s why I had a long beard;
foregoing facts for notifying to any government offices concern for all legal intents
HARJINDER SINGH SIDHU BRAR

Affiant

at Marikina City, by HARJINDER SINGH SIDHU BRAR who has satisfactorily proven his
competent evidence of identity through his Passport No. H7861028, that he is the same person
who personally signed before me the foregoing Affidavit and acknowledged that he executed the
same.

Notary Public
Page No. 07 : IBP No. 1057744 / 01-05-2017 /RSM
Book No. 142 : Roll. No. 52694
Series of 2017. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69
MARIKINA CITY………………....) S.S
AFFIDAVIT
I, AVTAR SINGH BADWAL, of legal age, Indian citizen and a resident of No. 14-C
Catherine Street Sta. Teresita Village, Malanday, Marikina City, after having been duly sworn to
in accordance with the law, do hereby deposes and state:
1. That I am holding an Indian Passport No. L9459450 issued on 21-05-2014 expires

on 20-05-2024 issued by the Republic of India;
2. That I have clean cut hygiene on my personal appearance which appeared in my

Indian Passport and I don’t had a beard before;
3. That since then and up to the present, I decided not to cut my beard all over my face,
that’s why I had a long beard;
foregoing facts for notifying to any government offices concern for all legal intents
AVTAR SINGH BADWAL

Affiant

at Marikina City, by AVTAR SINGH BADWAL who has satisfactorily proven his competent
evidence of identity through his Passport No. L9459450, that he is the same person who
personally signed before me the foregoing Affidavit and acknowledged that he executed the
same.

Notary Public
Page No. 18 : IBP No. 1057744 / 01-05-2017 /RSM
Series of 2017. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69
MARIKINA CITY………………. ) S.S
AFFIDAVIT
I, ANASTACIA VILLAN MENDIOLA-LOPEZ, of legal age, Filipino citizen and a resident of

No. 77 Dona Juliana Street Filinvest East Homes, Antipolo City, after having been duly sworn to in
1. That I am a holder of US Passport No. 221032197 issued on 02-21-2007 and valid until 02-
20-2017 issued by United States of America;
2. That I am definitely leaving the country after this Tourist Visa extension when I undergo an
operation at the hospital, as per Medical Certificate;
3. That I am overstaying for more than six (6) months due to my medication;
4. That I have executed this Affidavit to attest to the truth and veracity of all the foregoing for
all legal intents and legitimate purpose this may serve.
ANASTACIA VILLAN MENDIOLA-LOPEZ

Affiant
SUBSCRIBED AND SWORN to before me this _________________________ at Marikina

City. Affiant exhibited to me her Non-Professional Driver’s License No. X01-00-050398 expires on 09-
26-2015 issued at LTO, Quezon City.
Doc. No. 163 :

Page No. 33 :
Book No. 57 :
Series of 2015.
I, EMERSON S. ABRERA, of legal age, Filipino citizen and a resident of Block 17 Lot 13
Phase 5 Marycris Malagasang II-G, Imus Cavite, after having been duly sworn to in accordance with the
law, do hereby deposes and state;
1. That I was employed at SM Hypermarket Molino since November 2014 until April 2015;
2. That after then, I decide to go home and take a vacation at our province in Cebu, I stayed for
almost a months;
3. That due to my excitement, I forgot to claim my back pay at SM Hypermarket Molino;
4. That at present, I desire to claim my back pay;
5. That I am executing this affidavit to attest as to the truth of the foregoing statements in order
to comply with the requirements needed for the release of my back pay at SM Hypermarket
Molino and for all legal intents and legitimate purpose this may serve.
EMERSON S. ABRERA
Affiant

City. Affiant exhibited to me his Phil-health ID # 01-025690622-3.
Doc. No. 282 :

Page No. 57 :
Book No. 81 :
Series of 2016.
AFFIDAVIT OF NO CLAIM
I, ROBERT R. SALUTA, of legal age, Filipino citizen and a resident of Ayuste Bldg.
Marcos Highway, Cainta Rizal, after having been duly sworn to in accordance with the law, do
hereby deposes and state;
1. That I am the Attorney-in-fact of one (1) unit of motor vehicle, as per Special Power
of Attorney, which is more particularly described as follows:
Make : Mercedes Benz G550 Serial No. : WDCYC3HFXCX197267

Type : SUV Motor No. : 27396330460170
Model : 2013 Plate No. : WNQ767
File No. : 1312-00000391478
2. That I was the one who filed the alarm in connection of the above-described vehicle
under the registered owner, Aimardo V. Interior to the office of HPG;
3. That therefore, there is no claims shall arise;
4. That I am willing to comply all necessary documents pertaining for the release of
alarm in the said vehicle from HPG;
ROBERT R. SALUTA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ________________________ at

Marikina City, by ROBERT R. SALUTA who has satisfactorily proven his competent evidence of
identity through his Driver’s License # N01-89-092377, that he is the same person who
same.
Notary Public
Doc. No. 270 : IBP No. 019109 / 12-20-2017 /RSM
MCLE V – 0022100 / 04-14-2019
Book No. 185-B : No. 6 Mariano Arcade, Gunting Street,
Series of 2018. Midtown San Roque, Marikina City
Tel. No. 736-1168 / 736-11-69

MARIKINA CITY………………...) S.S
AFFIDAVIT OF ADMISSION
I, FLORANTE O. CASTILLO, of legal age, Filipino citizen and a resident of No. 30 Ivan III
Kingsville Subdivision, Antipolo City, after having been duly sworn to in accordance with the law, do
hereby deposes and state;
1. That I have been charged for Damage To Property thru Reckless Imprudence under I.S. no.
83-7230 at Quezon City Hall;
2. That said case has been settled on or before June 11, 1988. However, all records with Quezon
City Hall were burned on June 11, 1988;
3. That at present, I have no pending case, as per Certification;
FLORANTE O. CASTILLO
Affiant

City. Affiant exhibited to me his Non-Professional Driver’s License No. N15-75-016239 valid until 09-
19-2015 issued at LTO, Quezon City.
Doc. No. 446 :

Page No. 90 :
Book No. 59 :
Series of 2015.

MARIKINA CITY……………..……..) S.S
AFFIDAVIT OF NON-REGISTRATION
I, NOMELUNA D. CANLAS, of legal age, Filipino citizen with postal address at No. 22
Ubas Street Town & Country Executive Village, Mayamot, Antipolo City, after having been duly
1. That I am the registered and lawful owner a business known as “GTE

ENTERPRISES”, with business address at No. 22 Ubas Street Town & Country
Executive Village, Mayamot, Antipolo City;
2. That GTE ENTERPRISES has no registration since the business registered and
operated last January 2013 up to the present from Social Security System with one
(1) employee, namely:
a. Erlinda S. Tubog
3. That I am willing to comply all necessary documents needed for the registration of
the said business with Pag-IBIG Fund ;
NOMELUNA D. CANLAS
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this _________________________ at

Marikina City, by NOMELUNA D. CANLAS who has satisfactorily proven her competent
evidence of identity through her Phil-health # 19-089979597-4, that she is the same person who
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.

MARIKINA CITY………………...) S.S
SWORN STATEMENT
We, SPOUSES ERNESTO B. BARLIZO and FATIMA E. BARLIZO, both of legal

age, Filipino citizens and residents of No. 8 Woodpecker Street Francisville, Mambugan,
Antipolo City, after having been duly sworn to in accordance with the law, do hereby deposes
and state;
8. That we are the registered and lawful owner of a certain parcel of land identified as
Lot 28-A situated in the Barrio of Mambugan, Municipality of Antipolo, Province of
Rizal, Island of Luzon, covered by Transfer Certificate of Title No. 231768;
9. That I Ernesto B. Barlizo, having an investment with regards for the Insurance Plan
from Insular Life under Policy Nos. V200068446, V100131791, V100133474,
V100188198 & V100007299;
10. That we have two (2) Savings Account with Banco De Oro, to wit:
a. Account No. 000630177767- Rep-Con Engg. Services Corporation

b. Account No. 000630143056 – under our name
11. That we hereby declare all the assets and liabilities of the above-mentioned real
properties;
AFFIANT WE SAYETH NAUGHT.
ERNESTO B. BARLIZO FATIMA E. BARLIZO

Affiant Affiant

at Marikina City, by ERNESTO B. BARLIZO and FATIMA E. BARLIZO who has
satisfactorily proven their competent evidence of identity through their
______________________ __________________________________, that they are the same
person who personally signed before me the foregoing Sworn Statement and acknowledged that
they executed the same.
Doc. No. 323 :

Page No. 65 :
Book No. 98 :
Series of 2016.

AFFIDAVIT
I, PIO DORADO DOMA, of legal age, Filipino citizen, with postal address at Block 12 lot 14
phase 2 B2 Katungkulan Karangalan Village, Manggahan, Pasig City, after having been duly sworn to in
1. That I am the contractor for the elevation of the ground floor located at No. 3 Phase 2
Balimbing Street Town & Country Executive Village, Mayamot, Antipolo City under the
registered owner of Charito P. Nacz;
2. That the construction start on November 08, 2014 and ends of February 05, 2015;
PIO DORADO DOMA

Affiant

City. Affiant exhibited to me his TIN No. 440-377-261-000.
Doc. No. 365 :

Page No. 73 :
Book No. 52 :
Series of 2015.

CITY OF MARIKINA……..………. ) S.S
AFFIDAVIT OF NON-SUBMISSION
I, AUGUSTO M. MADLANGBAYAN, of legal age, Filipino citizen, and a resident of No.

26 B2 Monserrat Hill Drive La Milagrosa Village, Marikina Heights, Marikina City, after having
been duly sworn to in accordance with law depose and say:
1. That I am the father of Anthony Huelar Madlangbayan, born on November 18,

1980 in Riyadh, Kingdom of Saudi Arabia;
2. That the mother of the child is Asuncion P. Huelar;
3. That my common-law-wife holds our Philippine Passport at the time of birth of our
son and she safekeeping in her private/personal belongings;
4. That I failed to submit the necessary documents particularly our Philippine Passport,
due to my common-law-wife never said anything where she kept our Passport until
she passed away, all exert and effort to find the said Passport, it proved futile;
5. That I am willing to comply all necessary documents pertaining for the registration of
Report of Birth of my son from Department of Foreign Affairs;
6. That I am executing this affidavit to attest to the truth of the foregoing facts and for
whatever legal intents and purpose this may serve.
AUGUSTO M. MADLANGBAYAN
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ______________________ at

Marikina City, by AUGUSTO M. MADLANGBAYAN who has satisfactorily proven his
competent evidence of identity through his OSCA # 7445, that he is the same person who
same. ATTY. ANNA THERESA C. CRUZ
Notary Public
IBP No. 019109 / 12-20-2017 /RSM
Doc. No. 09 : Roll. No. 52694
Page No. 02 : MCLE V – 0022100 / 04-14-2019
Book No. 185-B : No. 6 Mariano Arcade, Gunting Street,
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA……………..) S.S
AFFIDAVIT
I, CORAZON P. CATER, of legal age, Filipino citizen and a resident of No. 119 Doña
Juana Subdivision 1600 Santolan, Pasig City, after having been duly sworn to in accordance with
law depose and say:
1. That I am the planholder and registered owner of a Life Plan under Policy No.
0428623365 from Philam Life;
2. That based on my Policy Contract did not matched the covered insured amount in
terms of 10 to 20 years which the agent Meny Santiago and Family offered and deal
with me, as follows:
a. For 10 years period – covered of Php359.903.00
b. For 20 years period – covered of Php799.785.00
c. Plus another living benefit amounting ofPhp1,097,337.00 (from
dividends and cash value) onwards
d. In case of withdrawn of the said plan, I am no longer be insured for the
rest of my life, hereto attached the agreed written of the agent
3. That therefore, whatever the mutual agreement between me the agent for the said plan
covered period is true and correct;
CORAZON P. CATER
Affiant

at Marikina City, by CORAZON P. CATER who has satisfactorily proven her competent
evidence of identity through her OSCA # 22966, that she is the same person who personally
Doc. No. :
Page No. :
Book No. :
Series of 2016.

CITY OF MARIKINA……….…….) S.S
AFFIDAVIT OF CLAIM
I, MARK OLIVER P. GABUTERO, of legal age, Filipino citizen, and a resident of Block 124
Lot 12 K66 Karangalan Village, San Isidro, Cainta Rizal, after having been duly sworn to in accordance
with law depose and say:
1. I am currently employed by Accenture, Inc.;

2. My permanent residence, as reflected in my company records, located at Block 124 Lot 12
K66 Karangalan Village, San Isidro, Cainta Rizal was damaged by the calamity/flooding that
occurred last Friday, September 19, 2014 due to typhoon Mario;
3. As proof of the damage to my residence, I hereby attach a duly issued Barangay Certificate
which reflects my name and address and the fact that my residence was indeed damaged by
the calamity;
4. The said residence is the same residence that was declared to HR as permanent residence;
5. I understand and represent that I am only entitled to the Calamity Assistance specific to
above-mentioned calamity only once and that aside from this claim I have never filed for a
Calamity Assistance with Accenture for the same incident;
6. I am executing this affidavit to attest to the truth of the foregoing and for the purpose of
supporting my claim for Calamity Assistance.
MARK OLIVER P. GABUTERO
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ____________________________ at

Marikina City, by MARK OLIVER P. GABUTERO who has satisfactorily proven his competent
evidence of identity through his UMP No. CRN-0111-0484308-1, that he is the same person who
personally signed before me the foregoing Affidavit and acknowledged that he executed the same.
Doc. No. 209 :

Page No. 42 :
Book No. 29 :
Series of 2015.

AFFIDAVIT OF CLAIM
I, MADONNA M. NASOL, of legal age, Filipino citizen, and a resident of No. 12 Pikador Street
Midtwon Subdivision, San Roque, Marikina City, after having been duly sworn to in accordance with law
depose and say:
1. That I am currently employed by Accenture, Inc., with postal and office address at Global
One, Eastwood Libis, Quezon City;
2. That my permanent residence, as reflected in my company records located at No. 12 Pikador

Street Midtwon Subdivision, San Roque, Marikina City was damaged by the
calamity/flooding that occurred last Friday, September 19, 2014 due to typhoon Mario;
3. That our village/house was flooded are soaked with water and mud;
4. That I understand and represent that I am only entitled to the Calamity Assistance specific to
above-mentioned calamity only once and that aside from this claim I have never filed for a
Calamity Assistance with Accenture for the same incident;
5. That I am executing this affidavit to attest to the truth of the foregoing and for the purpose of
supporting my claim for Calamity Assistance.
MADONNA M. NASOL
Affiant

Marikina City, by MADONNA M. NASOL who has satisfactorily proven her competent evidence of
identity through her Company ID No. 10067597 issued at Accenture, that he is the same person who
Doc. No. 92 :
Page No. 19 :
Book No. 30 :
Series of 2015.

JOINT-AFFIDAVIT OF CONSENT
We, IMELDA G. SANDOVAL and EDNA L. LOPE, of legal age, Filipino citizens and
residents of Lot 14 Block 84 Patricia Homes 6 Alley 3, Panganiban Street, Concepcion Dos, Marikina
City, after having been duly sworn to in accordance with law depose and say:
1. That we are the long time neighbors of Manuel Aguilar Medrano;

2. That he decide to put up a business known as Palm Beach Princess Printing Press located
at Lot 14 Block 84 Patricia Homes 6 Alley 3, Panganiban Street, Concepcion Dos, Marikina
City;
3. That we have no objection to the said business, on the contrary, we give our consent to this
application fully and freely by declaring under oath;
4. That we hereby giving our full consent and allows, Manuel Aguilar Medrano to put-up
business of the above-address;
5. That we are executing this affidavit to attest to the truth of the foregoing facts for the
application of business license with Municipality of Marikina and for whatever legal intents
and purposes this may serve.
FURTHER WE SAYETH NAUGHT.
IMELDA G. SANDOVAL EDNA L. LOPE

Affiant Affiant

Marikina City, by IMELDA G. SANDOVAL and EDNA L. LOPE who has satisfactorily proven their
competent evidence of identity through their Driver’s License No. D16-02-272788 & SSS # 03-8190078-
0, that they are the same person who personally signed before me the foregoing Joint-Affidavit and
acknowledged that they executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT
I, MARIETTA C. CRUZ-OLAIVAR, of legal age, Filipino citizen with postal address at

Sumulong Hi-way Corner Aguinaldo Street Sto. Niño, Marikina City, after having been duly sworn to in
accordance with law depose and say:
6. That I am an Internal Medicine-Neurology under License No. 62188, PTR No. 4982918 and
S2 No. 00138383RM14-028;
7. That I am the doctor of Francisco Belga;
8. That the above patient is under my care because of multiple strokes;
9. That he has left hemiparesis, he cannot write with paucity of verbal output although he can
comprehend;
10. That I am executing this affidavit to attest to the truth of the foregoing facts and for whatever
legal intents and purposes this may serve.
MARIETTA C. CRUZ-OLAIVAR
Affiant

Marikina City, by MARIETTA C. CRUZ-OLAIVAR who has satisfactorily proven her competent
evidence of identity through her License No. 62188, that he is the same person who personally signed
before me the foregoing Affidavit and acknowledged that he executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT
I, IRINEO C. GONZALES JR., of legal age, Filipino citizen with postal address at No. 35
Kalakhan Street Doña Betang Subdivision Santolan, Pasig City, after having been duly sworn to
in accordance with law depose and say:
1. That I am the registered and lawful owner of a business known as “BIG
CONSTRUCTION”, a single proprietor under and by virtue of the laws of the Philippines,
with principal office and business address at No. 35 Kalakhan Street Doña Betang
Subdivision Santolan, Pasig City, under TIN No. 235-228-311-000;
2. That it is hereby authorized users to register and enroll the said business with Bureau of
Internal Revenue for making it mandatory for taxpayers included in the Taxpayer
Account Management Program (TAMP) and to make use of the Electronic Filing and
Payment System (EFPS) facility in filing their returns and making payments of their taxes
due thereon, hence to wit:
Name Position E-mail address
a. IRINEO C. GONZALES JR. General Manager big@yahoo.com

b. LOLITA C. GONZALES Finance Manager lolitagonzales331@yahoo.com
c. LILIA C. GONZALES HR/Admin. Manager letletgonzales@yahoo.com
3. That I am executing this affidavit to attest to the truth of the foregoing facts with Bureau
of Internal Revenue and for whatever legal intents and purposes this may serve.
IRINEO C. GONZALES JR.

Affiant

at Marikina City, by IRINEO C. GONZALES JR. who has satisfactorily proven his competent
evidence of identity through his TIN # 235-228-311-000, that he is the same person who
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.

AFFIDAVIT
I, IRINEO C. GONZALES JR., of legal age, Filipino citizen with postal address at No. 35
Kalakhan Street Doña Betang Subdivision Santolan, Pasig City, after having been duly sworn to in
1. That I am the registered and lawful owner of a business known as “BIG CONSTRUCTION”, a
single proprietor under and by virtue of the laws of the Philippines, with principal office and
business address at No. 35 Kalakhan Street Doña Betang Subdivision Santolan, Pasig City, under
TIN No. 235-228-311-000;
2. That upon submission of the requirements with Security Bank and transmitted to Bureau of
Internal Revenue, I found out that have an a typographical error of the said Affidavit per docketed
as Doc. 222; Page No. 45; Book No. 44; Series of 2015 dated 02-17-2015 under notarial registry
book of Atty. Anna Theresa C. Cruz for and in Marikina City, which stated and inscribed as
big@yahoo.com;
3. That I hereby request and inform with Security Bank & BIR to change my e-mail address from
big@yahoo.com to big.cons@yahoo.com;
IRINEO C. GONZALES JR.

Affiant

Marikina City, by IRINEO C. GONZALES JR. who has satisfactorily proven his competent evidence of
identity through his TIN # 235-228-311-000, that he is the same person who personally signed before me
the foregoing Affidavit and acknowledged that he executed the same.
Doc. No. 19 :
Page No. 04 :
Book No. 46 :
Series of 2015.

CITY OF MARIKINA……….…..….) S.S
AFFIDAVIT
I, MANNY M. JOVES, of legal age, Filipino citizen and a resident of Block 41 Lot 04
Purok I, Brgy. Lawang Pare, Bulacan, after having been duly sworn to in accordance with the
1. That I am an employee of CLM IMPROVEMENT COMPANY;
2. That I have been employed in the said company since January 2018 and up to the
present and I am competent to perform my duties;
3. That I am aware that the said business are not yet registered the members of
employees to the office of Social Security System since January 2018;
4. Furthermore, I have no pending Administrative/Civil nor criminal case filed against

my person;
5. That I am executing this affidavit to attest to the truth of the foregoing facts to comply
the necessary documents with regards for the registration to Social Security System
and for whatever legal intents and purposes this may serve.
MANNY M. JOVES
Affiant

at Marikina City, by MANNY M. JOVES who has satisfactorily proven his competent evidence of
identity through his Company ID # 07, that he is the same person who personally signed before
Notary Public
IBP No. 019109 / 12-20-2017 /RSM
Book No. 185-B : MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA…….………...) S.S
We, SPOUSES JAY FLORES TULIAO and GENEROSE VIERNES TULIAO, both of legal age,
Filipino citizens, and residents of No. 38 Block 3 Cojuangco Homes Tanguile Street, Marikina Heights,
Marikina City, after duly sworn to, in accordance with law, hereby depose and say:
1. That we are the parents of SOPHIA ROSE V. TULIAO, born on March 22, 2017 in Marikina
City;
2. That we intend to apply her a Philippine Passport from DFA, SM Cherry Antipolo;
3. That our daughter is not yet attending to any school because she is only 2 years old and she
doesn’t have any of the Identification Cards, she only have an authenticated birth certificate
and baptismal certificate;
4. That one of the requirements in DFA, SM Cherry Antipolo is the submission of any valid ID;
5. That we are executing this affidavit to attest to the truth of the foregoing facts and for whatever
IN WITNESS WHEREOF, we hereunto set our signature this 26 th day of June 2019 in Marikina City,
Philippines.
JAY FLORES TULIAO GENEROSE VIERNES TULIAO

Affiant Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 26th day of June 2019 at Marikina City, by
SPOUSES JAY FLORES TULIAO and GENEROSE VIERNES TULIAO who has satisfactorily proven their
competent evidence of identity through their Driver’s License # N01-14-037446 and UMID # 01113286963-
9, that they are the same person who personally signed before me the foregoing Joint-Affidavit and
Notary Public
Doc. No. 12 : IBP No. 063029 / 01-03-2019/RSM
Book No. 182 : MCLE VI – 0025188 / 04-4-2022
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA…….……...) S.S
AFFIDAVIT
I, LEODEGARIO P. REYES, of legal age, Filipino citizen and a resident of No. 237 Sitio
Victoria Avenue, Brgy. San Juan, Cainta Rizal, after having been duly sworn to in accordance with law
hereby depose and say;
1. That my outstanding obligation from Union Bank reaching more than Php400,000.00 as of
2013 including charges and penalties’
2. That I am offering a settlement for Php200,000.00 all in for auto loan, insurance and credit
card;
3. That if ever granted the amount of Php200,000.00, payments shall made as follows:
a. Php50,000.00 - will paid on November 26, 2014

b. Php150,000.00 - payable on December 19, 2014
4. That I already submit the request letter for settlement offer for Auto Loan, Insurance and
Credit Card dated November 18, 2014 under Legal Division, Union Bank;
legal intents and purpose this may serve.
LEODEGARIO P. REYES
Affiant

Marikina City, by LEODEGARIO P. REYES who has satisfactorily proven his competent evidence of
identity through his Postal No. 2947543 expires on 12-2015, that he is the same person who personally
signed before me the foregoing Affidavit and acknowledged that he executed the same.
Doc. No. 225 :

Page No. 45 :
Book No. 37 :
Series of 2015.

CITY OF MARIKINA……………) S.S
AFFIDAVIT
I, CORAZON RUELOS MARTINEZ, of legal age, Filipino citizen, and a resident of No. 12
Tyrone Street Tierra Pura Homes Tandang Sora, Quezon City, after having been duly sworn to in
1. That I am the wife of the late JOSE BERNARDO MARTINEZ, registered owner of two (2)
parcels of land covered by Transfer Certificate of Title No. 38206 & 38207, containing an
area of 240 square meters & 240 square meters, more less, under Tax Declaration No. 26-
177-03397-R & 26-177-03390-R;
2. That when I verified the property holdings of the said deceased from the Assessor’s Office,
Caloocan City, I found out that he has three (3) properties declared;
3. That I state under oath, that any charges filed in my husband name, bear the same name only
of JOSE BONIFACIO MARTINEZ appeared in property holdings and he is not the same
person and he have different identities and of different addresses;
4. That I hereby certify and oath that he is not the same who appeared in the said property
holdings;
5. That therefore, he have no pending case;
6. That he have no liabilities from any bank and or any government and private offices;
CORAZON RUELOS MARTINEZ
Affiant

Marikina City, by CORAZON RUELOS MARTINEZ who has satisfactorily proven her competent
evidence of identity through her _____________________________, that she is the same person who
personally signed before me the foregoing Affidavit and acknowledged that she executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA…………….) S.S
AFFIDAVIT
I, ELSA M. TY, of legal age, Filipino citizen, and a resident of No. 101 A Poinsettia Street Sonia
Subdivision, Brgy. Dela Paz, Pasig City, after having been duly sworn to in accordance with law depose
and say:
1. That I am the common-law-wife of the late Victor H. Ty;
2. That were living together as husband and wife without the benefit of marriage and out of two
(2) children, namely:
a. Marivic T. Mendoza
b. Mira Chrystel M. Ty
3. That he is a bonafide member of Social Security System with No. 03-1882501-6;
4. That I am executing this affidavit to attest to the truth of the foregoing facts and for the death
claim of the late Victor H. Ty with Social Security System and for whatever legal intents and
ELSA M. TY
Affiant

Marikina City, by ELSA M. TY who has satisfactorily proven her competent evidence of identity
through her SSS # 03-6061399-1, that she is the same person who personally signed before me the
foregoing Affidavit and acknowledged that she executed the same.
Doc. No. 112 :

Page No. 23 :
Book No. 59 :
Series of 2015.

CITY OF MARIKINA…………..….) S.S
AFFIDAVIT OF NON-EMPLOYMENT
I, LORETO VICENTA M. JUMAWAN, of legal age, Filipino citizen, and a resident of No.
24 Flamingo Street Brgy. San Roque, Marikina City, after having been duly sworn to in
1. That I was born on February 27, 1972 in Manila;

2. That I am presently not employed in any employment or business;
3. Furthermore, I have no pending Administrative/Civil nor Criminal case filed against

my person;
4. Therefore, I am unemployed and no income to be declared;
LORETO VICENTA M. JUMAWAN

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 5th day of July 2018 at Marikina
City, by LORETO VICENTA M. JUMAWAN who has satisfactorily proven her competent
evidence of identity through her SSS # 33-1790198-3, that she is the same person who
same.
Notary Public
Page No. 14 : IBP No. 019109 / 12-20-2017 /RSM
Series of 2018. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA…………….. ) S.S
I, ELY JOSHUAH D. BOLOCON, of legal age, Filipino citizen, and a resident of No. 31
Lime Street, SSS Village, Concepcion Dos, Marikina City, after having been duly sworn to in
1. That I am the fiancée of Diane C. Nuñez;
2. That when I filled-up the application form of our Marriage License, I had wrote my
address as No. 30 Olive Street, SSS Village, Concepcion Dos, Marikina City;
3. That days after, upon reviewing my documents I found out that I had commit mistake on
the Number and Street of my residence and I in hurry to dropped at the City Hall of
Marikina;
4. That the Registration Officer III, Dolora E. Sario shall make counter sign on our
Marriage License for the reason of having an erroneous at my residence indicated as No.
30 Olive Street and it should be as the No. 31 Lime Street;
5. That I also decided to make counter sign the other erroneous in my necessary documents
with regards for the application of our Marriage License to correct my real address as No.
31 Lime Street;
6. That truth of the matter, I am bonafide resident at No. 31 Lime Street, SSS Village,
Concepcion Dos, Marikina City;
7. That the said erroneous and alteration in the said documents without means to defraud
any person;
ELY JOSHUAH D. BOLOCON

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ___________________ at

Marikina City, by , ELY JOSHUAH D. BOLOCON who has satisfactorily proven his competent
evidence of identity through his UMI # 0111-6746319-4, that he is the same person who personally
signed before me the foregoing Affidavit and acknowledged that he executed the same.
Notary Public
Doc. No. 412 : Appointment No. 07 (2018-2019)
Page No. 83 : IBP No. 019109 / 12-20-2017 /RSM
Book No. 161-b : Roll. No. 52694
Series of 2018. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA……….….. ) S.S
AFFIDAVIT
I, STEPHANIE FE DAN, of legal age, Filipino citizen, and a resident of Lot 15 Block 1-B La
Montana Estate Brgy. Dela Paz, Antipolo Rizal, after having been duly sworn to in accordance with law
depose and say:
1. That I am the registered and lawful owner of three (3) storey residential house situated in
Lot 15 Block 1-B La Montana Estate Brgy. Dela Paz, Antipolo Rizal;
2. That I hired three (3) persons to construct and supervise the said project known as three (3)
storey residential house to wit:
a. Deogracias C. Pascual - Electrical Engineer

b. Marlon A. Buhain - Structural Civil Engineer
c. Josefino Lucas - Architect
STEPHANIE FE DAN
Affiant

Marikina City, by STEPHANIE FE DAN who has satisfactorily proven her competent evidence of
identity through her __________________________________, that she is the same person who
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA………….. ) S.S
AFFIDAVIT
I, CATHERINE C. DIAMANTE, of legal age, Filipino citizen and a resident of No. 28 Austin
Street, Provident Village, Marikina City, after having been duly sworn to in accordance with law hereby
depose and say;
1. I am a bonafide member/pensioner of the Social Security System under SSS No. 33-0936670-1;
2. I did not file with the SSS an application for loan;
3. I have neither received, endorsed, assigned nor appointed anybody to negotiate said check;
4. Other Information:
 I did not apply for SSS Loan on April 6, 1999 under employer name Sinclair Phils. Inc.
and did not receive Check number 7956281 dated April 14, 1999 contrary to the records
of SSS.
 Please see attached documents as proof of my employment with Philam Plans on

February 1, 1999, thus, application of loan under Sinclair Phils. Inc. could not be possible
as I was no longer with Sinclair at the time of SSS loan application record.
 Please make appropriate correction as SSS records show that my balance principal is
P8,250.30, meaning there has been an accidental payment of P2,749.70 to a loan
(amounting to P11,000.00 as per SSS record) that has never been applied in the first
place.
 Interest is also reflected in my SSS record when there has been no loan applied and check
was never received.
5. I am executing this document to attest to the foregoing facts and support my request for correction
of my SSS Records.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ____________________ at

Marikina City.
CATHERINE C. DIAMANTE
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this __________________________ at Marikina

City, by CATHERINE C. DIAMANTE who has satisfactorily proven her competent evidence of identity
through her ________________________________, that she is the same person who personally signed before
me the foregoing Affidavit and acknowledged that she executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT
WE, CRESCENCIA MACSIEB ISAGUIRRE, SABAS M. ISAGUIRRE, JR. and JOSE
SARAHNEL M. ISAGUIRRE, all of legal age, Filipino citizens and residents of #20 Garnet Street,
Doña Juana Subdivision, Rosario, Pasig City, after having been duly sworn to in accordance with law
1. That we are the surviving heirs of Sabas M. Isaguirre of a parcel of land, located at Pinugay,
Baras, Rizal with an area of 17,535 square meters, more or less, covered by TCT No. M-
3546/EPNo. 677990 which was awarded in the name of deceased Sabas M. Isaguirre by the
Department of Agrarian Reform (DAR) as farmer beneficiary;
2. That the foregoing described property is not involved in any pending case before any quasi-
judicial body or regular courts;
3. That this affidavit is executed in compliance with DAR Administrative Order No. 8 (199) as
well as to show proof that abovementioned property is not involved in any pending case.
CRESCENCIA MACSIEB ISAGUIRRE SABAS M.

ISAGUIRRE, JR.
(Affiant) (Affiant)
JOSE SARAHNEL M. ISAGUIRRE

(Affiant)

Marikina City, by CRESCENCIA MACSIEB ISAGUIRRE, SABAS M. ISAGUIRRE, JR., and
JOSE SARAHNEL M. ISAGUIRRE who has satisfactorily proven their competent evidence of identity
through their _______________________________________________________________, that they are
the same person who personally signed before me the foregoing Affidavit and acknowledged that they
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA………….….) S.S
AFFIDAVIT
I, DICK NATIVIDAD IPO, of legal age, Filipino citizen and a resident of Block 11 Lot
3 Lefaga Street The Tropics Filinvest East, Cainta Rizal, after having been duly sworn to in
accordance with law hereby depose and say:
1. That I was formerly employed at Ace Veterinary Clinic for a period of two (2) years
and five (5) months;
2. That I was hired on March 1, 2010 until August 30, 2012;
DICK NATIVIDAD IPO

Affiant

at Marikina City, by DICK NATIVIDAD IPO who has satisfactorily proven his competent
evidence of identity through his ___________________________, that he is the same person
same.
Notary Public
Doc. No. : PTR No. 6669108 / 01-03-2017 / Marikina City
Page No. : IBP No. 1057744 / 01-05-2017 /RSM
Book No. : Roll. No. 52694
MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA………………..) S.S
AFFIDAVIT
I, MASAO KURODA, of legal age, Japanese citizen and a resident of Lot 12 & 14 Block 6 45
Carnation Street, Lacolina Subdivision, Parang, Marikina City, after having been duly sworn to in
accordance with law hereby depose and say;
1. That I am the registered and holder of a Japan Passport with No. TK7754243 issued on 08-
21-2012 and expires on 08-21-2022 issued by Japan;
2. That I am more than willing to extend my stay here in the Philippines for good and as a
permanent residence;
3. That I want to stay in this beautiful country because my only son married a Filipina and stay
here in the Philippines. So that why where leaving alone on our country, so my son want me
to stay in the Philippines together with his wife and family;
4. That I hereby request the Bureau of Immigration to grant my stay for the above-purposes;
5. That I am executing this affidavit to attest to the truth of the foregoing facts and willing to
submit any requirements with Bureau of Immigration and for whatever legal intents and
MASAO KURODA
Affiant

Marikina City, by MASAO KURODA who has satisfactorily proven his competent evidence of identity
through his Japan Passport with No. TK7754243 expires on 08-21-2022 issued by Japan, that she is the
same person who personally signed before me the foregoing Affidavit and acknowledged that she
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA……………....) S.S
AFFIDAVIT OF EMPLOYMENT
I, ANNABEL L. DELA PAZ, of legal age, Filipino citizen with office address at Unit 102
G/F RDJ Center Bldg. # 10 Marcos Hi-way, Mayamot, Antpiolo City, after having been duly
sworn to in accordance with law hereby depose and say:
1. That I am the registered and lawful owner of NAILBOX SALON & SPA, a single
proprietor, with business address at Unit 102 G/F RDJ Center Bldg. # 10 Marcos Hi-
way, Mayamot, Antpiolo City;
2. That Jeraldine S. Dizon is an employee of my business started on February 1, 2019

and up to the present, holding an appointment with the position of Nail Technician/
Massage Therapist/Facialist and Manager;
3. That I hereby certify and testify that she is my employee and issue this upon the
request of Ms. Dizon to comply with her application of NC II;
4. That this affidavit is executed to attest the truth of all the foregoing and for any other
purposes it may lawfully serve.
ANNABEL L. DELA PAZ

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 22nd day of February 2019 at

Marikina City, by ANNABEL L. DELA PAZ who has satisfactorily proven her competent
evidence of identity through her Driver’s License # N02-11-010195, that she is the same person
the same.
Notary Public
Doc. No. 207 : IBP No. 063029 / 01-03-2019/RSM
MCLE V – 0022100 / 04-14-2019
Book No. 199 : No. 6 Mariano Arcade, Gunting Street,
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA…………....) S.S
AFFIDAVIT OF UNDERTAKING
I, CRESELLA QUIAL MOSTEIRO, of legal age, Filipino citizen and presently residing at
Padilla Brgy. Inarawan, Antipolo City, after having been duly sworn to in accordance with law hereby
depose and say;
1. That I am the owner of Marc & Toto Aircon Services registered last June 13, 2014;
2. That said business address has no TCT and was acquire by undersigned by means of Transfer
of Rights;
3. That I undertake to voluntarily vacate said premises in the event that another person who has
superior rights over the said property has been found and asserted his rights over the same.
4. That this affidavit of promissory note is executed to attest the truth of all the foregoing and
for any other purposes it may lawfully serve.

CRESELLA QUIAL MOSTEIRO
Affiant

Marikina City. Affiant exhibited to me her _____________________________________.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT
WE, of legal age, a naturalized American citizen and a resident of #104 Milan Street, Pasig
Greenpark Village, Pasig City, after having been duly sworn to in accordance with law hereby depose and
say;
1. That I am the co-owner’s of my brother Antonio Millan Castillo inherited from my mother
Juliana Millan of the one (1) parcel of land located at #8 Redeemer Street, Brgy. New Era,
Quezon City, containing an area of 557 square meters, more or less, covered by Transfer
Certificate of Title No. 80394;
2. That upon inspection to my aforementioned parcel of land Mr. Magtoto constructed a

residential house for his personal family dwelling;
3. That I did not authorized and give consent to Mr. Magtoto and anybody to construct any
improvements on the above stated parcel of land;
4. That therefore, I hereby request the Engineering Department of Quezon City to demolish all
the improvements found and existing thereon due to illegal building and occupancy of
Magtoto;
RODOLFO MILLAN CASTILLO

Affiant

Marikina City, by RODOLFO MILLAN CASTILLO who has satisfactorily proven his competent
evidence of identity through his SSS No. 03-2200848-9, that he is the same person who personally signed
before me the foregoing Affidavit and acknowledged that he executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT OF NO COLLECTION
I, GEORGE B. PADILLA, of legal age, married to Genoveva G. Padilla, Filipino citizens and
residents of No. 9 Sparrow Street, Francisville, Mambugan, Antipolo City, after having been duly sworn
to in accordance with law hereby depose and say;
1. That I am the General Manager of GEORGE B. PADILLA & ASSOCIATES, a single

Proprietor Company, duly organized and existing under the laws of the Philippines with
principal office at No. 9 Sparrow Street, Francisville, Mambugan, Antipolo City;
2. That said Company has not collected any contribution for PAG-BIG Fund from employee
Mr. Silverio Blando from his date of employment June- December 2012; and
3. That this affidavit is being executed in order to attest to the truth of the foregoing
circumstances and for the purpose of complying with the requirements of the PAG-IBIG.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ____________________

at Marikina City.
GEORGE B. PADILLA
Affiant
Marikina City, by GEORGE B. PADILLA who has satisfactorily proven his competent evidence of
identity through his Non-Professional Driver’s License No. N15-76-003599 valid until 02-22-2016 issued
at LTO, Quezon City, that he is the same person who personally signed before me the foregoing Affidavit
and acknowledged that he executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA………….….. ) S.S
AFFIDAVIT
I, CONCORDIA R. GARCIA, of legal age, Filipino citizen and a resident of Block 45 Lot 4 Avida
Parkway Settings Canlubang, Calamba, Laguna, after having been duly sworn to in accordance with law
depose and say:
1. That I am the holder or I was issued the following document, as follows:
 Deed of Sale of Motor Vehicle
2. That I hereby attest to the authenticity and genuineness of the documents and paper/attached
and made an integral part;
3. That I hereby agree to be liable and answerable to perjury and/or falsification of public
documents in the event that the documents are found not in order.
CONCORDIA R. GARCIA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 29th day of December, 2020 at Marikina City,
by CONCORDIA R. GARCIA, who has satisfactorily proven her competent evidence of identity through her
Passport#P8436157A, that she is the same person who personally signed before me the foregoing Affidavit
and acknowledged that she executed the same.
ATTY. MA. ELENA T. MARALLAG-CAJUCOM

Notary Public
Page No. 11 : PTR No. MKT8116089/01-02-2020/Marikina City
Book No. 51 : IBP Lifetime Member No. 014749/05-26-2016/Cagayan
Roll. No. 52831
Series of 2020. MCLE VI 0028635 valid until 04-14-2022
Tel. No. 8631-25-60

AFFIDAVIT OF NON-RECEIPT
I, FELICISIMO P. NAVARRO, of legal age, Filipino citizen with postal address at No.
933 Edsa Philam, Quezon City, after having been duly sworn to in accordance with law hereby
depose and say;
1. That I am the registered and lawful owner of GLC TRUCK & EQUIPMENT, with
office and business address at No. 933 Edsa Philam, Quezon City;
2. That Mr. Benjamin Tan Alonzo issued a Manager’s Check payment for the repair of
his Mercedez Benz;
3. That therefore, I have not yet received the Manager’s Check;
FELICISIMO P. NAVARRO
Affiant

at Marikina City, by FELICISIMO P. NAVARRO who has satisfactorily proven his competent
evidence of identity through his ________________________________, that he is the same
person who personally signed before me the foregoing Affidavit and acknowledged that he
executed the same. ATTY. ANNA THERESA C. CRUZ
Notary Public
Doc. No. : IBP No. 019109 / 12-20-2017 /RSM
Page No. : Roll. No. 52694
MCLE V – 0022100 / 04-14-2019
Book No. : No. 6 Mariano Arcade, Gunting Street,
Tel. No. 736-1168 / 736-11-69

AFFIDAVIT OF NON-RECEIPT OF SALARY LOAN

I, GERMILINA SOLOMA GARCIA, of legal age, Filipino citizen and a resident of
Lot 11 Block 40 Phase 2 C3 Karikitan Street Brgy. Manggahan, Karangalan Village, Pasig City,
after having been duly sworn to in accordance with law hereby depose and say:
1. That I am a bonafide member of Social Security System under SS No. 33-5972626-5;
2. That I did not file with the SSS an application for loan;
3. That I have not yet received the Salary loan check with No. 15015438 dated August
01, 2007 amounting of Php24,000.00;
4. That I have neither received, endorsed, assigned nor appointed anybody to negotiate
said check;
GERMILINA SOLOMA GARCIA
Affiant

at Marikina City, by GERMILINA SOLOMA GARCIA who has satisfactorily proven her
competent evidence of identity through her SSS # 33-5972626-5, that she is the same person who
same.
Doc. No. 173 :

Page No. 35 :
Book No. 103 :
Series of 2016.

AFFIDAVIT
I, SEVERINA C. ALCANTARA, of legal age, Filipino citizen and a resident of Block 4

Lot 17 English Street Teachers Village, Manggahan, Pasig City, after having been duly sworn to
in accordance with law hereby depose and say:
1. That I am the Teacher/Coordinator of San Lorenzo Ruiz Elementary School located

at Kapitagan, Kaalinsabay Street, Karangalan, Manggahan, Pasig City;
2. That the canteen of the said school have three (3) suppliers for gas tank, as follows:
a. Royal Flame Venture located at No. 10 Kaginhawaan Road Karangalan
Village, Manggahan, Pasig City;
b. Eduardo D.G. Quitenis located at Magsaysay Street Manggahan, Pasig City;
c. Vol Vic Flame Ventures located at No. 21 Alcalde Jose Street Kapasigan
Street, Pasig City;
3. That the above-mentioned suppliers did not issued an Official Receipt wherever they
delivered in the said school;
4. That therefore, there is no Official Receipt;
SEVERINA C. ALCANTARA
Affiant

at Marikina City, by SEVERINA C. ALCANTARA who has satisfactorily proven her
competent evidence of identity through her ________________________________, that she is
the same person who personally signed before me the foregoing Affidavit and acknowledged that
she executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2016.

CITY OF MARIKINA……………. ) S.S
AFFIDAVIT
I, NICANOR A. SERIA, of legal age, single, Filipino citizen and a resident of RC Gonzales
Cpd. Amang Rodriguez Avenue, Pasig City, after having been first duly sworn according to law hereby
depose and state;
1. That I am the General Manager of the firm NAS CONSTRUCTION COMPANY, a single
proprietor duly organized and existing under the laws of the Republic of the Philippines, with
main office location at the above-mentioned postal address;
2. That the firm NAS CONSTRUCTION is accredited as SUBCONTRACTOR OF WILL

DECENA & ASSOCIATES INC.., the General Contractor for the construction of the
STAR MALL SAN JOSE BULACAN PROJECT located at San Jose Del Monte, Bulacan;
3. That the firm NAS CONSTRUCTION, has fully paid in accordance with the Minimum
Wage Laws the wages of all its laborers and workers employed and bills for materials used
and all subcontractor, if any, for the construction of the STAR MALL SAN JOSE
BULACAN PROJECT;
4. That the firm NAS CONSTRUCTION, hereby assumes all responsibilities and liabilities in
the event of any claim for materials and labors used and employed in the aforesaid project
and for the fees and taxes due to the Government by virtue thereof and hereby hold the STAR
MALL SAN JOSE BULACAN PROJECT free and harmless form any claim,
responsibilities or damage out of or, in connection with its Contract in the Project
aforementioned;
5. That this affidavit is being executed for the purpose of securing the release of payment for
PROGRESS BILLING NO. – REINFORCING BARS INSTALLATION AND
FABRICATION for the above-mentioned project.
IN WITNESS WHEREOF, I have hereunto affixed my hand this ________________________

in Marikina City.
NICANOR A. SERIA
Affiant

Marikina City, by NICANOR A. SERIA who has satisfactorily proven his competent evidence of
identity through his PRC License No. 0039792 expires on 06-05-2017, that he is the same person who
Doc. No. 435 :

Page No. 87 :
Book No. 41 :
Series of 2015.

AFFIDAVIT
I, NELINDA N. NARES, of legal age, Filipino citizen, and a resident of No. 41 Kaparangan
Street, Karangalan Village, Pasig City, after having been duly sworn to in accordance with law hereby
depose and say;
1. That I am the registered and lawful owner of two (2) real properties, which are more
particularly described as follows:
a.) Five (5) Doors Apartment, with an area of 100 square meters, located at No. 41
Kaparangan Street, Karangalan Village, Pasig City;
b.) House & Lot, 103 square meters, located at Cabuyao, Laguna;
2. That my husband ALFONSO NARES is a bonafide member of Social Security System

under SSS No. _____________________, which may receive pension amounting to
Php2,500.00 per month;
3. That the aforementioned real properties rented and leased amounting to Php30,000.00 as
monthly rental;
4. That as such, I have received an income of THIRTY TWO THOUSAND FIVE

HUNDRED PESOS (Php32,500.00) Philippine Currency, as monthly income;
5. That undersigned for the purpose of loan and transacting business with the government
agencies and private institution;
NELINDA N. NARES
Affiant

Marikina City, by NELINDA N. NARES who has satisfactorily proven her competent evidence of
identity through her CTC No. 16331544 issued on 04-02-2013 issued at Pasig City, that she is the same
person who personally signed before me the foregoing Affidavit and acknowledged that she executed the
same.
Doc. No. 346 :

Page No. 70 :
Book No. 50 :
Series of 2015.

AFFIDAVIT OF NO CHANGE
I, EDGAR C. QUIAO, of legal age, Filipino citizen and a resident of No. 36 Valencia Street, P-
IA, Vista Verde Executive Village, Cainta Rizal, after having been duly sworn to in accordance with law
1. This is to inform your good office that EURO CARPETS AND INTERIORS AND ITS
WAREHOUSE is still located at No. 36 Valencia Street, P-IA, Vista Verde Executive
Village, Cainta Rizal;
2. This affidavit is being issued by the undersigned for the purpose of transacting business with
the government agencies;
EDGAR C. QUIAO
Affiant

Marikina City, by EDGAR C. QUIAO who has satisfactorily proven his competent evidence of identity
through his Professional Driver’s License No. D16-99-214985 valid until 01-23-2014 issued at LTO,
Quezon City, that he is the same person who personally signed before me the foregoing Affidavit and
acknowledged that he executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT OF WITHDRAWAL
I, GLENN E. NABO JR., of legal age, Filipino citizen and a resident of No. 145-D Camia Street
Corner Street Sonia Subidivsion Dela Paz, Pasig city, after having been duly sworn to in accordance with
law hereby depose and say;
1. That I was applied at Mercan Canada Employment Phils. Inc., located at Unit 506 Galleria
Corporate Center Edsa Corner Ortigas Avenue, Quezon City;
2. That I hereby request and inform the said agency to pull-out and withdraw my application as
well as to refund my processing fee amounting to Php7,500.00 due to I am no longer
interested;
GLENN E. NABO JR.

Affiant

Marikina City, by GLENN E. NABO JR. who has satisfactorily proven his competent evidence of
identity through his Non-Professional Driver’s License No. N01-08-008465 expires on 01-13-2017 issued
at LTO, Quezon City, that he is the same person who personally signed before me the foregoing Affidavit
and acknowledged that he executed the same.
Doc. No. 225 :

Page No. 45 :
Book No. 31 :
Series of 2015.

AFFIDAVIT OF INCAPACITY
I, EDILBERTA V. REYES, of legal age, Filipino citizen, and a resident of No. 212 Piña Street,
Balanti, Cainta Rizal, after having been duly sworn to in accordance with law hereby depose and say;
1. That I am the registered and lawful owner of the one (1) parcel of land situated in
Lot 3-A, Brgy of Balanti, Municipality of Cainta, Province of Rizal, Island of
Luzon, containing an area of 53 square meters, more or less, covered by Transfer
Certificate of Title No. 669171;
2. That I am applying additional meter of the above stated real property for personal
use under Application No. 32222013030181;
3. That I can’t write my signature over my printed name anymore due to my

incapacity;
4. That I am executing this affidavit to attest to the truth of the foregoing facts and
for whatever legal intents and purpose this may serve.
EDILBERTA V. REYES
Affiant

Marikina City, by EDILBERTA V. REYES who has satisfactorily proven her competent evidence of
identity through her _______________________________________, that she is the same person who
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT
I, ANTWERP T. JUNIO, of legal age, Filipino citizen and a resident of b8 l12 Franceville
Subdivision, Bulihan S Cavite, after having been duly sworn to in accordance with law hereby depose and
say;
1. That I have shown my interest or intent to buy a parcel of land owned by Carlos De Guzman
situated in Lot 13-G, Brgy. of Esperanza, Municipality of Alfonso, Province of Cavite,
containing an area of 108 square meters, more or less, covered by Transfer Certificate of Title
No. T-52980;
2. That, NARCISA MARTIN is authorized to process all the documents for the sale of
property;
3. That I have given her Php200,000.00 for the processing of the reconstitution, petition and
transfer of the said property;
4. That I am no longer interested to buy the aforementioned parcel of land, therefore, I request
Ms. Narcisa Martin to return back the amount of Php200,000.00 as refund;
5. That I am willing to receive staggered payment through postdated checks, since there were
incurred expenses during the processing of documents;
ANTWERP T. JUNIO
Affiant

Marikina City, by ANTWERP T. JUNIO who has satisfactorily proven his competent evidence of
identity through his Professional Driver’s License No. N26-04-000516 and Comp. ID No. 33839, that she
is the same person who personally signed before me the foregoing Affidavit and acknowledged that he
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT OF NON-EMPLOYEE
I, EVANGELINE CRUZ VILLAFLOR, of legal age, Filipino citizen with postal and business
address at No. 18 Harding Street, West Greenhills, San Juan, Metro Manila, after having been duly sworn
1. That I am the sole owner/proprietress of a business known as “EVANSVILLE

ENTERPRISES”, a single proprietor duly organized and existing bylaws under the Republic
of the Philippines with office and business address at No. 18 Harding Street, West Greenhills,
San Juan, Metro Manila, under TIN No. 202-962-460-002;
2. That my BIR Certificate of Registration registered activity Tax Type- Withholding Tax-
Compensation under TIN-202-962-460-002;
3. That at present, I never hired employee for said business operation;
4. That as such I am the only one who manage the above stated business;
EVANGELINE CRUZ VILLAFLOR

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ___________________________ at

Marikina City, by EVANGELINE CRUZ VILLAFLOR who has satisfactorily proven her competent
evidence of identity through NBI # V441E03LOR13NE18ALM, that she is the same person who
Doc. No. :
Page No. :
Book No. :
Series of 2015.

SWORN STATEMENT
I, ANITA ANG CANADALLA, of legal age, Filipino citizen with postal and business address at
Cadena De Amor Corner Lavander, Mayamot, Newtown, Antipolo City, after having been duly sworn to
in accordance with law hereby depose and say;
1. That I am the President of a business known as “ZAPATOS MARKETING INT’L”, a

corporation duly organized and existing bylaws under the Republic of the Philippines with
business address at Cadena De Amor Corner Lavander, Mayamot, Newtown, Antipolo City;
2. That Cadena De Amor corner Lavander, Mayamot, Newtown Antipolo City is used only as a
“warehouse”;

ANITA ANG CANADALLA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ___________________________ at

Marikina City, by ANITA ANG CANADALLA who has satisfactorily proven her competent evidence
of identity through Passport # XX26891808 valid until 12-11-2013 issued at DFA, Manila, that she is the
same person who personally signed before me the foregoing Affidavit and acknowledged that she
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA…………..) S.S
STATUTORY DECLARATION
I, VICTORIA ALVAREZ CABUNGCAL, of legal age, married, Filipino citizen with postal
address at No. 532 Servillana Street, UE Village, Cainta Rizal, after having been duly sworn to in
1. That I will travel to Port Moresby, Papua New Guinea;
2. That I will be temporarily staying in my husband’s residence at Varahe Road, Gordons, NCD
with Contact No. (675) 3255559;
3. That I am not employed, elsewhere in the Philippines and/or connected with any firm.
4. That my husband will undertake me while I stay abroad so that I will not become a public
burden while in Papua New Guinea.
5. That I intend to travel and remain in Papua New Guinea as a genuine visitor and, hence, will
not be employed, whether paid or unpaid and I will return before my visa expires in the
Philippines.
6. That I make this solemn declaration by virtue of the Statutory Declaration Act 1959 as
amended and subject to the penalties provided by that Act for the making of false statements
in statutory declarations, conscientiously believing the statement contained in this declaration
to be true in every particular.
VICTORIA ALVAREZ
CABUNGCAL
Affiant

Marikina ity, by VICTORIA ALVAREZ CABUNGCAL who has satisfactorily proven her competent
evidence of identity through her Passport No. XX322394 valid until 03-11-2014 that she is the same
person who personally signed before me the foregoing Affidavit and acknowledged that she executed the
same.
Doc. No. :
Page No. :
Book No. :
Series of 2015.

CITY OF MARIKINA……………...) S.S
AFFIDAVIT
I, ROVINA R. MAYNIGO, of legal age, Filipino citizen and a resident of No. 182 A. Luna
Street, Project 4, Quezon City, after having been duly sworn to in accordance with law hereby
depose and say:
1. That I am presently employed at CERTAIN GENERAL INSURANCE AGENCY

CORPORATION, with office and business address at Unit 403 The STG Corporate
Centre Bldg. #76 Timog Avenue, Sacred Heart, Quezon City;
2. That upon verification of Membership Contributions Remittance Form (MCRF) of the

employees in the said business from Pag-IBIG Fund for the month of October 2017
and other months in the year 2017, I found out that my registered Pag-IBIG No.
inscribed as 1210-7044-6311 which my monthly contribution pay to that Pag-IBIG
No.;
3. That truth of the matter, my real and correct Pag-IBIG No. is 0009-1943-7404, as per
MCRF for covered period of June 2017;
4. That I hereby request to the office of Pag-IBIG Fund to transfer my contribution for
the month of October 2017 and other months of 2017 on my real Pag-Ibig No. as
0009-1943-7404.
the necessary documents and for whatever legal intents and purpose this may serve.
ROVINA R. MAYNIGO
Affiant
Conforme:
DENNIS A. DIMAUNAHAN
President of Certain General Insurance Agency

Marikina City, by ROVINA R. MAYNIGO who has satisfactorily proven her competent evidence
of identity through her Driver’s License No. D16-00-234396, that her is the same person who
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.

AFFIDAVIT
I, DENNIS A. DIMAUNAHAN, of legal age, Filipino citizen with postal address at Unit
403 The STG Corporate Centre Bldg. #76 Timog Avenue, Sacred Heart, Quezon City, after
having been duly sworn to in accordance with law hereby depose and say:
1. That I am the President of CERTAIN GENERAL INSURANCE AGENCY

CORPORATION, with office and business address at Unit 403 The STG Corporate
Centre Bldg. #76 Timog Avenue, Sacred Heart, Quezon City;
2. That Milagros Ramos was formerly employed in the said business;
3. That she has no longer connected and performed duties since March 2017 and up to
the present;;
4. That GENERAL INSURANCE AGENCY CORPORATION is not liable to the monthly

contributions of Milagros Ramos;
the necessary documents and for whatever legal intents and purpose this may serve.
DENNIS A. DIMAUNAHAN
Affiant

Marikina City, by DENNIS A. DIMAUNAHAN who has satisfactorily proven his competent
evidence of identity through his _________________________________, that he is the same
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.

I, RYAN P. ANG ANGCO, of legal age, Filipino citizen and resident of #38 Alvarado Street,
Vista Verde Executive Village, San Isidro, Cainta, Rizal, after having been duly sworn to in accordance
with law hereby depose and say;
1. That I am the registered and lawful owner of a business name known as R.P ANG ANGCO
PAWNSHOP located at Stall #182 New Public Market, Urdaneta City;
2. That pursuant to the City Ordinance of Urdaneta City, Pangasinan, they required to me to put
CCTV Surveillance Camera for the safety of all business establishments against burglary;
3. That I hereby undertake to comply the above stated requirements so that my business license
be granted;
RYAN P. ANG ANGCO

Affiant

Marikina City, by RYAN P. ANG ANGCO who has satisfactorily proven his competent evidence of
identity through his Unified Multi –Purpose ID No. 0111-1210551-7, that he is the same person who
Doc. No. :
Page No. :
Book No. :
Series of 2015.

AFFIDAVIT OF INCOME
I, ADONIS FERNANDEZ GAZMIN, of legal age, Filipino citizen and a resident of Lot 2 Block 2
Phase II-E Vermont Royale executive Village, Mayamot, Antipolo City, after having been duly sworn to in
1. That I am the father of YAHZEE BENEDICT L. GAZMIN;
2. That my son intend to apply and enroll for Grade XI at Far Eastern University, Manila;
3. That I am self-employed and own a small canteen located at Sto. Niño, Marikina City, which I
received income with an average of Php10,000.00 per month;
4. That therefore, I have an income to be declared;
necessary requirements for his Educational Assistance and for whatever legal intents and
ADONIS FERNANDEZ GAZMIN

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 22nd day of July, 2020 at Marikina City, by
ADONIS FERNANDEZ GAZMIN, who has satisfactorily proven his competent evidence of identity through
his Driver’s License No. N02-93-214120, that he is the same person who personally signed before me the
foregoing Affidavit and acknowledged that he executed the same.
Doc. No. 496 :

Page No. 100 :
Book No. 30 :
Series of 2020.

CITY OF MARIKINA…………..….) S.S
AFFIDAVIT OF UNEMPLOYMENT
I, MA. TERESA ZABARTE DELA CRUZ, of legal age, Filipino citizen, and a resident of
No. 9 Peter Street Kingsville Subdivision Marcos Highway, Antipolo City, after having been duly
sworn to in accordance with law hereby depose and say:
1. That I was born on October 04, 1959 in Nasugbu, Batangas;
2. That at present, I am not engaged anymore in any employment or business, thus I

am only in full charity of my family and relatives;
3. Furthermore, I have no pending Administrative/Civil nor Criminal case filed against

my person;
4. Therefore, I have no income to be declared;
5. That I am executing this affidavit to attest to the truth of the foregoing facts in regards
for the correction of name from the Local Civil Registry in Nasugbu, Batangas and for
MA. TERESA ZABARTE DELA CRUZ

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 17th day of November 2020 at

Marikina City, by MA. TERESA ZABARTE DELA CRUZ who has satisfactorily proven her
competent evidence of identity through her __________________________________, that she
is the same person who personally signed before me the foregoing Affidavit and acknowledged
that she executed the same.
Doc. No. 384 :

Page No. 77 :
Book No. 44 :
Series of 2020.

CITY OF MARIKINA…………...…) S.S
I, MADELLEN P. TORDECILLA, of legal age, Filipino citizen and a resident of No. 129 Unit G.
Gen. Ordoñez, Marikina Heights, Marikina City, after having been duly sworn to in accordance with law
hereby depose and say:
1. That I was born on November 07, 1968 in Taal, Batangas;
2. That I am presently not employed;
3. That as such, I am not engage in any employment, thus I am not connected to any
company/agency, I am only in full charity of my family and relatives;
4. Furthermore, I have no pending Administrative/Civil nor criminal case filed against my person;
5. That I am executing this affidavit in order to attest to the truth of the foregoing circumstances
and requirements for ESC Application Program of my daughter Aaliyah Cristine T. Saman in
St. Scholastica Academy Marikina, Grade-7, and for whatever legal intents it may serve.
MADELLEN P. TORDECILLA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 08th day of July, 2020 at Marikina City, by
MADELLEN P. TORDECILLA who has satisfactorily proven her competent evidence of identity through her
Driver’s License No. N03-17-021346, that she is the same person who personally signed before me the
foregoing Affidavit and acknowledged that she executed the same.
Doc. No. 127 :

Page No. 26 :
Book No. 29 :
Series of 2020.
.
CITY OF MARIKINA……..…….….) S.S
I, CHERYL TONOLETE DETERA, of legal age, Filipino citizen and a resident of No. 9 Torrente
Street, Vista Verde Executive Village, Cainta Rizal, after having been duly sworn to in accordance with law
depose and say:
1. That I am the mother of JOSEPH ANDRIAN TONOLETE DETERA;
2. That my son intend to apply and enroll for Grade 11 using a Voucher from PEAC;
3. That at present, I am not engaged anymore in any employment or business, thus I am only in
full charity of my family and relatives;
4. Therefore, I am unemployed and I have no income to be declared;
necessary requirements for his Educational Assistance and for whatever legal intents it may
serve.
CHERYL TONOLETE DETERA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 17th day of August, 2020 at Marikina City, by
CHERYL TONOLETE DETERA, who has satisfactorily proven her competent evidence of identity through
her SSS#33-6832097-9, that she is the same person who personally signed before me the foregoing
Affidavit and acknowledged that she executed the same.
Doc. No. 159 :

Page No. 32 :
Book No. 33 :
Series of 2020.

AFFIDAVIT OF NON EMPLOYMENT
I, RODOLFO B. APOLINARIO, of legal age, Filipino citizen and a resident of No. 7

Marciano Street Vermont Royale, Antipolo City, after having been duly sworn to in accordance
with law depose and say:
1. That I was born on January 04, 1957 in Manila;
2. That I am a bonafide member of Social Security System under SS No. 03-4830677-0;
3. That I never been employed at Lee & Sons Printing Company since 04-1979 under
Employer ID No. 03-8695807-0 which appeared in my Employment History in Social
Security System;
4. That at present, I am not engaged anymore in any employment or business;
5. Therefore, I have no income to be declared;

RODOLFO B. APOLINARIO
Affiant

at Marikina City, by RODOLFO B. APOLINARIO who has satisfactorily proven his
competent evidence of identity through his Passport # EC3419874, that he is the same person
same.
Notary Public
Page No. 08 : Appointment No. 05 (2016-2017)
Book No. 123 : PTR No. 6669108 / 01-03-2017 / Marikina City
Series of 2017. IBP No. 1057744 / 01-05-2017 /RSM
Roll. No. 52694
MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

CITY OF MARIKINA……………….) S.S.
AFFIDAVIT OF INCOME
I, ADELAIDO C. SAMAN JR., of legal age, Filipino citizen and a resident of No. 129 G.
Gen. Ordoñez Street, Marikina Heights, Marikina City, after having been duly sworn to in
1. That I am the father of Aaliyah Christine T. Saman;
2. That my daughter intend to apply ESC Application Program in St. Scholastica

Academy Marikina, Grade-7;
3. That I am the registered owner of ANGELIYAH SIOMAI CORNER, with office and
business address at MRT Cubao Station;
4. That as such, the monthly income in the said business a maximum of FIFTY
THOUSAND PESOS (PHP50,000.00) Philippine Currency;
5. That therefore, I have income to be declared;
the ESC Application Program and for whatever legal intents and purpose this may
serve.

ADELAIDO C. SAMAN JR.
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 08th day of July, 2020 at Marikina
City, by ADELAIDO C. SAMAN JR. who has satisfactorily proven his competent evidence of
identity through his Driver’s License No. D06-96-167291, that he is the same person who
same.
Doc. No. 126 :

Page No. 26 :
Book No. 29 :
Series of 2020.

CITY OF MARIKINA…………… ..) S.S
AFFIDAVIT
I, CHERRY CARPIO PANTOJA, of legal age, Filipino citizen and a resident of No. 10
Laborada Dr. Corner Marco Peter Street Vermont Royale Subdivision, Mayamot, Antipolo City,
after having been duly sworn to in accordance with law depose and say:
1. That I was born on April 30, 1992 in San Antonio, Nueva Ecija;
2. That I cannot hire private lawyer to defend whatever case filed in my name due to
lack of money and puberty/crisis;
3. That I am not engaged in any employment or business, thus I am only in full charity
of my family and relatives;
4. Therefore, I am unemployed and I have no income to be declared;
CHERRY CARPIO PANTOJA

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 13th day of June 2018 at Marikina
City, by CHERRY CARPIO PANTOJA who has satisfactorily proven her competent evidence of
identity through her Postal No. E8315048454, that she is the same person who personally
Notary Public
Page No. 21 : PTR No. 7244231 / 01-03-2018 / Marikina City
Book No. 174-B : IBP No. 019109 / 12-20-2017 /RSM
Series of 2018. Roll. No. 52694
MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

AFFIDAVIT
I, CARLITO D. DUMANDAN, of legal age, Filipino citizen, and a resident of No. 62

Dumandan Street, Santolan, Pasig City, after having been duly sworn to in accordance with law
1. That I was employed at Olympia Business Machine for almost 10 years;
2. That after 2 years, I am not engage in any employment, thus I am not connected to
any company/agency;
3. That I am bonafide member of Social Security System under SSS No. 03-4960686;
4. That sometimes, I filled up the SSS Form as self-employed or voluntarily, thus, I

have no business or whatsoever;
5. That at present, I am a tricycle driver as my source of income;
CARLITO D. DUMANDAN
Affiant

Marikina City, by CARLITO D. DUMANDAN who has satisfactorily proven his competent
evidence of identity through his SSS No. 03-4960686-4, that he is the same person who
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.

AFFIDAVIT OF INCOME
I, EDYLE GLIEN D. PAUSAL, of legal age, Filipino citizen, and a resident of No. 24 Loja
Street Corner Barcelona Extension Phase 7 Vista Verde Executive Village, Cainta Rizal, after
having been duly sworn to in accordance with law hereby depose and say;
7. That I am the mother of;
8. That my son intend to apply ;
9. Therefore, I have my source of income to be declared;
EDYLE GLIEN D. PAUSAL

Affiant

Marikina City, by EDYLE GLIEN D. PAUSAL who has satisfactorily proven his competent
evidence of identity through his SSS No. 34-3198284-6, that he is the same person who
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.

AFFIDAVIT
I, BONA V. BALASBAS, of legal age, Filipino citizen and resident of No. 1B Amethyst
Street, Cainta Greenpark Village, Cainta Rizal, after having been duly sworn to in accordance
1. That I am the Lessor and registered owner of an apartment located at No. 10-H
Amethyst Street, Cainta, Greenpark Village, Cainta Rizal;
2. That I and ROSALIE V. CRUZ was my tenant of the above-stated leased premises
from December 1, 2011 end of December 1, 2012, with monthly payment of
Php6,500.00;
3. That we executed and enter into Contract of Lease per docketed as Doc. No. 08;
Page No. 02; Book No. 31; Series of 2012 under the notarial book of Atty. Ernesto G.
Gasis, for and in Marikina City, dated on December 2, 2011;
4. That at present, YASMIN ALYSSA CRUZ is now my new tenancy of the said
premises and agreed as well as the same of terms and conditions of the Lease
Contract executed between me and ROSALIE V. CRUZ;
BONA V. BALASBAS
Affiant
Conforme:
YASMIN ALYSSA CRUZ

Marikina City, by BONA V. BALASBAS who has satisfactorily proven her competent evidence
of identity through her Non-Professional Driver’s License No. D16-06-011367 valid until 04-24-
2015, that she is the same person who personally signed before me the foregoing Affidavit and
acknowledged that she executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2013.

AFFIDAVIT
I, REYNALDO N. MARCELO, of legal age, Filipino citizen and resident of No. 11 Kapwa
Street, Midtown Subdivision, San Roque, Marikina City, after having been duly sworn to in
1. That I am the Lessor and registered owner of the house located at No. 11 Kapwa
Street, Midtown Subdivision, San Roque, Marikina City;
2. That SHERYLL MARCELO is my tenant of the above-stated premises and agreed to

pay a monthly rental of Php18,000.00. Likewise, tenant shall pay all the charges for
water, electric and other service facilities rendered and used in the leased premises
during the existence of the lease.
3. That I certify that SHERYLL MARCELO is currently residing and renting the fully
furnished house mentioned above;
REYNALDO N. MARCELO
Affiant
Conforme:
SHERYLL MARCELO

Marikina City, by REYNALDO N. MARCELO who has satisfactorily proven his competent
evidence of identity through his Professional Driver’s License No. N08-70-008666 valid until 09-
07-2014 issued at LTO, Quezon City, that he is the same person who personally signed before
Doc. No. :
Page No. :
Book No. :
Series of 2018.

CITY OF MARIKINA……….…......) S.S
AFFIDAVIT OF ADJOINING OWNER
We, MARIA C. HERRERA and ROMEO BUHAY, both of legal age, Filipino citizens and
residents of Brgy. Natipuan, Nasugbu, Batangas, after having been duly sworn to in accordance
with law hereby depose and say:
1. That we personally know EMELITA REYES ESTANISLAO, having our long time
neighborhood and we resides within the area of of Brgy. Natipuan, Nasugbu, Batangas;
2. That she is the claimant of a certain parcel of land located at Brgy. Natipuan, Nasugbu,
Batangas, containing an area of 750 square meters and the land falls within the
alienable and disposable area as per LC Map No. 3276, Project No. 29 dated June 29,
1987;
3. That she is presently applying for Residential Free Patent under REFA No. 041019-13
of the above-described real property from the DENR, Region IV-A (CALABARZON);
4. That the said real property is not claimed by other person except EMELITA REYES
ESTANISLAO;
5. That therefore, the area is suited for the purpose to which it is being applied for;
6. That, we are executing this affidavit to attest to the truth of the foregoing facts to comply
with the requirements and for whatever legal intents it may serve.
IN WITNESS WHEREOF, we are signing this instrument this ____________________
at Marikina City.
MARIA C. HERRERA ROMEO BUHAY

Affiant Affiant

Marikina City, by MARIA C. HERRERA and ROMEO BUHAY who has satisfactorily proven
their competent evidence of identity through their ___________________________, that they
are the same person who personally signed before me the foregoing Affidavit and
Doc. No. :
Page No. :
Book No. :
Series of 2018.

We,
 CELIA SAMSON, residing at No. 4 Walnut Street Marikina East Subdivision, San Roque,
Marikina City;
 DAVID P. SAMSON, residing at No. 200 JP Rizal Street, San Roque, Marikina City;
 FACUNDO P. SAMSON, No. 178 JP Rizal Street, San Roque, Marikina City;
 FRANCISCA SAMSON TONGO, No. 178 JP Rizal Street, San Roque, Marikina City;
 GLORIA SAMSON LASCO, No. 1 Walnut Street Marikina East Subdivision, San Roque,
Marikina City;
 ROBERTO DELA PAZ SAMSON, residing at No. 158 JP Rizal Street, San Roque,
Marikina City,
all of legal age, all Filipino citizens, after having been duly sworn to in accordance with law hereby
depose and say:
1. That we are the registered and lawful owners of a certain real property situated in the
Bulawan, San Roque, Bagumbayan, Pililla, Rizal, covered by Tax Declaration No. 10-001-
02209, with an area of EIGHT THOUSAND FIVE HUNDRED (8,500) SQUARE METERS,
which are more particularly described as follows:
Boundaries:
North : Hrs. of Fidela Olea South : Dimas Ramos

East : C. Aquino et. al West : Hrs. of Tecla Quitiong
2. That in our capacity as registered owners, we hereby unconditionally warrant the absolute
title and peaceful ownership of the above-described real property and we hereby declare that
the same is free from any liens, suit, claims or encumbrances whatsoever, or any matter
which may prove adverse thereto
3. That we hereby undertake to defend such title, as well as assume, and satisfy any suits or
claims resulting there from, without cost, charge or liability whatsoever accruing to its official,
staff, personnel and other government offices concerned;
4. That we are executing this affidavit to attest to the truth of the foregoing facts, to warrant the
ownership of the above-described property and for whatever legal intents and purposes this
may serve.
IN WITNESS WHEREOF, we hereunto set our signature this ________________________ at

Marikina City, Philippines.
CELIA SAMSON DAVID P. SAMSON

AFFIANT AFFIANT
FACUNDO P. SAMSON FRANCISCA SAMSON TONGO

AFFIANT AFFIANT
GLORIA SAMSON LASCO ROBERTO DELA PAZ SAMSON

AFFIANT AFFIANT
SIGNED IN THE PRESENCE OF:
_______________________________ ________________________________
Witness Witness
ACKNOWLEDGEMENT

MARIKINA CITY………………….) S. S
I certify that on ________________________, before me, a notary public duly authorized in

the city named above to take acknowledgments, personally appeared:
NAME Proof of Identity

CELIA SAMSON OSCA # 22245
DAVID P. SAMSON TIN # 471-226-213-000
FACUNDO P. SAMSON OSCA # 71910
FRANCISCA SAMSON TONGO OSCA # 46795
GLORIA SAMSON LASCO OSCA # 70465
ROBERTO DELA PAZ SAMSON OSCA # 16770
who were identified by me through competent evidence of identity to be the same persons described
in the foregoing instrument, who acknowledged before me that their respective signatures on the
instrument, were voluntarily affixed by them for the purposes stated therein, and who declared to me
that they have executed the instrument as their free and voluntary act and deed.
WITNESS MY HAND AND SEAL on the date and place first above-written.
Doc. No. :
Page No. :
Book No. :
Series of 2019.
AFFIDAVIT OF POSESSION/CUSTODY
I, MISCHEL N. CARPIO, of legal age, Filipino citizen and a resident of Block 5A Lot 13
Grayville Street, Sierra Monte Mansion, Cainta Rizal, after having been duly sworn to in
1. That I am the new owner of a certain motor vehicle, as per Deed of Sale of Motor
Vehicle, which is more particularly described as follows:
Make : Mitsubishi L300 Serial No. : L039PYZ1-18563

Model : 1998 Motor No. : 4D56A-H1551
Type : V. Van Plate No. : WAV182

CR No. : 47640510 File No. : 1372-195136
2. That since then and up to the present, said unit is under my possession and custody;
3. That in my capacity as new owner, I hereby unconditionally warrant the ownership

and possession of the said motor vehicle;
warrant the ownership of the above-described motor vehicle and for whatever legal
intents and purposes this may serve.
MISCHEL N. CARPIO
Affiant

Marikina City, by MISCHEL N. CARPIO who has satisfactorily proven her competent evidence
of identity through her __________________________________, that she is the same person
the same.
Doc. No. :
Page No. :
Book No. :
Series of .

I, NESTOR OLARTE VINLUAN, of legal age, Filipino citizen and a resident of No. 126
Doña Juliana Filinvest East Marcos Highway, Antipolo City, after having been duly sworn to in
5. That I am the rightful and lawful owner of one (1) Painting/Artwork, described as
follows:
TITLE : Ochre On Gray to Black

MEDIUM : Acrylic on Canvas
SIZE : 40x30 inches
DATE : 2011
6. That in my capacity as rightful owner, I hereby unconditionally warrant the absolute

title and ownership of the above-described Painting/Artwork;
7. That I hereby undertake to defend such title, as well as assume, and satisfy any suits
or claims resulting there from, without cost, charge or liability whatsoever;
warrant the title and ownership of the above-described Painting/Artwork and for
NESTOR OLARTE VINLUAN

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 22nd day of April 2019 at Marikina
City, by NESTOR OLARTE VINLUAN who has satisfactorily proven his competent evidence of
identity through his Employee ID # 221033167, that he is the same person who personally
signed before the foregoing Affidavit and acknowledged that he executed the same.

Notary Public
Doc. No. 114 : IBP No. 063029 / 01-03-2019/RSM
MCLE V – 0022100 / 04-14-2019
Book No. 204 :
Tel. No. 736-1168 / 736-11-69
CITY OF MARIKINA…………........) S.S
AFFIDAVIT OF RESIDENCY
I, ALYNOR M. DELA CRUZ, of legal age, Filipino citizen and a resident of No. 279
Chico Street, San Jose, Montalban Rizal, after having been duly sworn to in accordance with
law hereby depose and say:
1. That I am the mother of Akeelah Julia M. Dela Cruz, born on April 27, 2007;
2. That since 2002 and up to the present, my families are living and residing at No. 279
Chico Street, San Jose, Montalban Rizal;
3. That my daughter intend to enroll for Grade 7 Junior High this coming school year
2019-2020 in San Jose National High School;
4. That therefore, I hereby declare that the above-stated address is my residency;
ALYNOR M. DELA CRUZ

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 25th day of April 2019 at Marikina
City, by ALYNOR M. DELA CRUZ who has satisfactorily proven her competent evidence of
identity through her _____________________________, that she is the same person who
personally signed before the foregoing Affidavit and acknowledged that she executed the same.

Notary Public
Doc. No. 309 : IBP No. 063029 / 01-03-2019/RSM
Book No. 204 : MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69
I, BUNJI KURATA, of legal age, Japanese citizen and a resident of No. 16 Mt.
Dhaulagiri Street Fairmount Hills, Brgy. Dela Paz, Antipolo City, after having been duly sworn to
in accordance with law hereby depose and say;
1. That I am a cardholder of Alien Cert. of Res. No. ICR-355152 under Immigrant Visa
No. E306723 as permanent;
2. That I am legally married to Ma. Elena S. Kurata;
3. That we have three (3) children, namely:
a. Naomi S. Kurata - born on January 14, 2000

b. Shoji S. Kurata - September 18, 2001
c. Yuji S. Kurata - December 16, 2004
4. That we live in No. 16 Mt. Dhaulagiri Street Fairmount Hills, Antipolo City since 2005
up to the present;
BUNJI KURATA
Affiant

Marikina City, by BUNJI KURATA who has satisfactorily proven his competent evidence of
identity through his Non-Professional Driver’s License No. X01-04-000713 expires on 08-17-
2015 issued at LTO, Quezon City, that he is the same person who personally signed before the
foregoing Affidavit and acknowledged that he executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.
CITY OF MARIKINA………….) S.S
AFFIDAVIT OF GUARDIANSHIP
I, WILMA B. BERNALDEZ, of legal age, Filipino citizens and residents of No. 10-A 504
NHA Kaginhawaan Street, Karangalan Village, Brgy. Manggahan, Pasig City, after having been
duly sworn to in accordance with law hereby depose and say;
1. That I am the guardian of the minor child JOZ REXEL B. MENDOZA;
2. That he was born on October 31, 2007 in Pasig City;
3. That I am the guardian of the minor child to claim/receive a one (1) unit of tablet
at Manggahan High School, Pasig City, for my nephew JOZ REXEL B.
MENDOZ, thus, I am willing to support him for whatever financial needs;
4. That I am executing this affidavit to attest to the truth of the foregoing facts and
WILMA B. BERNALDEZ
Affiant/Guardian
SUBSCRIBED AND SWORN TO BEFORE ME this 05th day October, 2020 at Marikina
City, by WILMA B. BERNALDEZ, who has satisfactorily proven her competent evidence of
identity through her Voter’s ID#7403-0756A-K1963WBB20000, that they are the same person
who personally signed before the foregoing Affidavit and acknowledged that they executed the
same.
Doc. No. 124 :

Page No. 25 :
Book No. 38 :
Series of 2020.
CITY OF MARIKINA………….) S.S
AFFIDAVIT OF GUARDIANSHIP
We, RONILO S. BAAL and KAREN D. JINTALAN, of legal age, Filipino citizens and
residents of No. 2 Mt. Kennedy Street, San Roque, Marikina City, after having been duly sworn
5. That we are the guardian of the minor child ICE DESPI JINTALAN;
6. That he was born on March 14, 2007 in Quezon City;
7. That the said child was applying of primary school for this school year, thus, we
are willing to support him for whatever financial needs;
8. That we are executing this affidavit to attest to the truth of the foregoing facts and
RONILO S. BAAL KAREN D. JINTALAN
Affiant Affiant

Marikina City, by RONILO S. BAAL who has satisfactorily proven his competent evidence of
identity through his Professional Driver’s License No. D16-02-265708 valid until 10-13-2013
issued at LTO, Quezon City, that they are the same person who personally signed before the
foregoing Affidavit and acknowledged that they executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2013.
CITY OF MARIKINA……….……...) S.S
I, ANGELO LAGARE RANIDO, of legal age, Filipino citizen and a resident of No. 2-C
Makiling Corner Banahaw Street HHV Concepcion Dos, Marikina City, after having been duly
sworn to in accordance with law hereby depose and say;
1. That I am presently applying as Cook with Mercan Agency;
2. That I was on-call hired Artist by my Production Assistant, Mr. Tommy Tantiangco
under 12 Stones Record since April 2010 to September 2013;
3. That I have no knowledge Mr. Tommy Tantiangco no whereabouts;
4. That therefore, I cannot request my Detailed Certificate of Employment for my

application;
ANGELO LAGARE RANIDO

Affiant

Marikina City, by ANGELO LAGARE RANIDO who has satisfactorily proven his competent
evidence of identity through his Driver’s License # D16-05-011055, that he is the same person
the same.
Doc. No. 202 :

Page No. 41 :
Book No. 66 :
Series of 2018.
CITY OF MARIKINA……….…...) S.S
I, RICHARD R. RAMOS, of legal age, Filipino citizen and a resident of Netra II Patiis
Road Malanday, San Mateo Rizal, after having been duly sworn to in accordance with law
1. That I am presently applying as Driver with R.M. Roa under Fast Logistic;
2. That I was resign last September 2015 verbally to my previous company at Vidanes
Transport directly to the owner Maria Teresita Vidanes without any formal letter for
resignation due to I am not satisfied their management and delayed salaries for their
employees;
3. That at present, Maria Teresita Vidanes cannot issue my certification due to her
hectic schedule;
4. That therefore, I cannot request my Detailed Certificate of Employment for my

application;
RICHARD R. RAMOS
Affiant

Marikina City, by RICHARD R. RAMOS who has satisfactorily proven his competent evidence
of identity through his Driver’s License # N25-11-023693, that he is the same person who
same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.
AFFIDAVIT
I, MARIA CRISTINA J. FERNANDEZ, of legal age, Filipino citizen and a resident of No.
126 Bay Dela Paz, Langhaya, Antipolo City, after having been duly sworn to in accordance with
law depose and say:
6. That I am the common-law-wife of the late JesusTolentino Zarate who died on

December 28, 2010 in Chinese General Hospital;
7. That we live together as husband and wife without the benefits of marriage and out of
said union Nathan Benedict F. Zarate;
8. That the said deceased has a bonafied member with Social Security System;
9. That I didn’t process the application of the death benefits of JesusTolentino Zarate due
to I’ve waited for long years to come back here in the Philippines the legal spouse,
Merlita M. Manangan;
10. That I am executing this affidavit to attest to the truth of the foregoing facts and willing to
submit any requirements pertaining to the death claim of JesusTolentino Zarate and for
MARIA CRISTINA J. FERNANDEZ

Affiant

at Marikina City, by MARIA CRISTINA J. FERNANDEZ who has satisfactorily proven her
competent evidence of identity through her PRC License # 0023801, that she is the same
person who personally signed before me the foregoing Affidavit and acknowledged that she
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.
CITY OF MARIKINA………….....) S.S
AFFIDAVIT OF CHANGE OWNERSHIP
I, BABY JEAN MENDOZA REDITA, of legal age, Filipino citizen and a resident of No. 4
Dao Street, Town & Country Executive Village, Marcos Highway, Brgy. Mayamot, Antipolo City,
after having been duly sworn to in accordance with law hereby depose and say:
1. That I am the registered and lawful owner of a Globe Landline with Internet from Globe
Telecommunication, Inc. under Account No. 848304428 and Telephone No. (02) 212-98-
45, located at the No. 4 Dao Street, Town & Country Executive Village, Marcos Highway,
Brgy. Mayamot, Antipolo City;
2. That I voluntarily and extinguished my participation and rights to the used of ownership
of the Globe Landline with Internet heretofore mentioned for whatever purpose and in
transfer the rights to its use and ownership in favor of HARJINDER SINGH BRAR, of
legal age, Indian citizen and resident of No. 4 Dao Street, Town & Country Executive
Village, Marcos Highway, Brgy. Mayamot, Antipolo City;
BABY JEAN MENDOZA REDITA

Affiant

Marikina City, by BABY JEAN MENDOZA REDITA who has satisfactorily proven her
competent evidence of identity through her _______________________________, that she is
the same person who personally signed before the foregoing Affidavit and acknowledged that
she executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2017.
CITY OF MARIKINA…….……....) S.S
AFFIDAVIT OF CIRCUMSTANCES
I, JESSIE CARPE CADANGDANG, of legal age, Filipino citizen, and a resident of No.
14-A Sta. Maria Marcos Highway, Pasig City, after having been duly sworn to in accordance
1. That I was born on January 26, 1993 in Bunawan, Davao City, parents of Spouses
Gloria Legara Carpe & Camilo Dayaan Cadangdang;
2. That my parents filled my birth certificate as late registration under Local Civil
Registry No. 94-892 due to negligence;
3. That I am presently applying for Automotive at Prudential Employment Agency Inc.;
4. That I am willing to comply all the necessary documents pursuant to the

requirements of the said agency with regards for the approval of my application;
JESSIE CARPE CADANGDANG

Affiant

Marikina City, by JESSIE CARPE CADANGDANG who has satisfactorily proven his competent
evidence of identity through his Driver’s License L02-12-008714, that she is the same person
the same.
Notary Public
IBP No. 019109 / 12-20-2017 /RSM
Book No. 159-b : Roll. No. 52694
Series of 2018. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69
CITY OF MARIKINA……………... ) S.S
I, RENATO JONJON V. CARUNCHO JR., of legal age, Filipino citizen and a resident of
No. 14 Liamzon Street, San Roque, Marikina City, after having been duly sworn to in
1. That I am the registered owner and Manager of FAMILY LODGE, with office and
business address at No. 14 Liamzon Street, San Roque, Marikina City;
2. That I hereby undertake to comply based on the following defects/deficiencies

required by the Bureau of Fire Protection in Marikina City under DILG for within a
period of one hundred (100) days, as follows:
a. To install Automatic Fire Suppression System (Sprinkler)

a. To install Fire Detection and Alarm System
b. To conduct Fire Safety Seminar and Drill
c. To install Directional Exit Signs
d. To install Additional Illuminated Exit Signs
e. To pay Fire Code Realty Tax
3. That I am willing to comply all the necessary documents pursuant to the

requirements of the Bureau of Fire Protection with regards of the said business;
RENATO JONJON V. CARUNCHO JR.

Affiant

Marikina City, by RENATO JONJON V. CARUNCHO JR. who has satisfactorily proven his
competent evidence of identity through his _________________________, that he is the same
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.
AFFIDAVIT OF NON-DEDUCTION
I, ROBERT P. CALISAY, of legal age, Filipino citizen with postal address at Lot 10
Block 1 Netra Subdivision, Maly, San Mate, Rizal, after having been duly sworn to in
1. That I am the registered and lawful owner of R.C.D.L. ENGINEERING

SERVICES, with office and business address at Lot 10 Block 1 Petra Subd. Maly,
San Mate, Rizal;
2. That the said business is not yet registered in Pag-IBIG Fund, therefore, no deduction
to all employees made since January 13, 2014 up to present, checklist of name of
employees hereto attached;
the necessary documents with Pag-IBIG Fund and for whatever legal intents and
ROBERT P. CALISAY
Affiant

at Marikina City, by ROBERT P. CALISAY who has satisfactorily proven his competent
evidence of identity through his _________________________________, that he is the same
executed the same.
Doc. No. :
Page No. :
Book No. :
Series of 2018.
CITY OF MARIKINA…………........) S.S
I, MERVIN ALCANTARA, of legal age, Filipino citizen and a resident of No. 279 Chico
Street, San Jose, Montalban Rizal, after having been duly sworn to in accordance with law
hereby depose and say:
1. That I am the father of Christine D. Alcantara, born on November 10, 2006;
2. That since 2002 and up to the present, my families are living and residing at No. 279
Chico Street, San Jose, Montalban Rizal;
3. That my daughter intend to enroll for Grade 7 Junior High this coming school year
2019-2020 in San Jose National High School;
4. That therefore, I hereby declare that the above-stated address is our residency;
MERVIN ALCANTARA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 25th day of April, 2019 at Marikina
City, by MERVIN ALCANTARA who has satisfactorily proven his competent evidence of identity
through his _____________________________, that he is the same person who personally
signed before the foregoing Affidavit and acknowledged that he executed the same.

Notary Public
IBP No. 063029 / 01-03-2019/RSM
Book No. 204 : Roll. No. 52694
Series of 2019. MCLE V – 0022100 / 04-14-2019
Tel. No. 736-1168 / 736-11-69

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REPUBLIC OF THE PHILIPPINES)

CITY OF MARIKINA………….....) S.S

4. That therefore, I desire to cancel the afore-cited business due to I am no longer

FURTHER I SAYETH NAUGHT.

EDWARD VINCENT R. CHENG

SUBSCRIBED AND SWORN TO BEFORE ME this _________________________

I, ZANZIBAR GUANZON MISAJON, of legal age, Filipino citizen and a resident of

2. That in my capacity as rightful owner, I hereby unconditionally warrant the absolute

FURTHER I SAYETH NAUGHT.

ZANZIBAR GUANZON MISAJON

SUBSCRIBED AND SWORN TO BEFORE ME this ___________________________

AFFIDAVIT OF NO EMPLOYEE & NO ALPHALIST OF PAYEE

1. That I am the co-owner of a business known as “RAGALARA BAKE HOUSE

2. That said “RAGALARA BAKE HOUSE COMPANY” is a partnership business;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 15th day of

EMELYN BELDUA REGALARIO

SUBSCRIBED AND SWORN TO BEFORE ME this 15th day of October, 2020 at

Doc. No. 391 :

YOLADA DIZON BATARA

SUBSCRIBED AND SWORN TO BEFORE ME this 21st day of September, 2020 at

Doc. No. 222 :

1. That I am the mother of Krisha Mhae Dandan Cordova;

2. That my daughter intend to apply and enroll for Grade XI;

3. That I am received a monthly remittance from my father-in-law amounting of Php4,000.00 per

4. That therefore, I have an income to be declared;

FURTHER I SAYETH NAUGHT.

JENELYN DANDAN CORDOVA

Doc. No. 238 :

1. I regularly receive professional/talent service fee or earn an income as Php13,962.00;

FURTHER I SAYETH NAUGHT.

EDGAR LORETO IMPERIAL

SUBSCRIBED AND SWORN TO BEFORE ME this 07th day of December, 2020 at

ATTY. MA. ELENA T. MARALLAG-CAJUCOM

IN WITNESS WHEREOF, the party signed this instrument, this ________________ at

JOSEPHINE BERNADAS ANGCANAN

SUBSCRIBED AND SWORN TO BEFORE ME this ______________ at Marikina City,

IN WITNESS WHEREOF, we have hereunto affixed our signature, this ______________

GURMOHAN SINGH BRAR

SUBSCRIBED AND SWORN TO BEFORE ME this __________________________

I, ANNE YOCHABEL L. NAMOCATCAT, of legal age, Filipino citizen and presently at

3. That I decided to cancel the Certificate of Registration as my profession to the office

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

ANNE YOCHABEL L. NAMOCATCAT

SUBSCRIBED AND SWORN TO BEFORE ME this __________________________ at

4. I cannot secure a Notice of Termination from my employer; and

NANDY A. PABLO JR.

Doc. No. 449 :

5. That the deceased is a payee in Globe Telecommunication under Metrobank

6. That as the surviving heirs, we are requesting Globe Telecommunication to consider

IN WITNESS WHEREOF, the parties signed this instrument, this ________________

ATTY. ANNA THERESA C. CRUZ

1. That I was born on September 26, 1953 in Manila;

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

SUBSCRIBED AND SWORN TO BEFORE ME this __________________________

AFFIDAVIT OF MINIMAL INCOME

IN WITNESS WHEREOF, I have hereunto affixed my signature, this _______________ in Marikina

SUBSCRIBED AND SWORN TO BEFORE ME this __________________________at Marikina City, by

Doc. No. 269 :

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Affirmation is made and executed into by and between:

SPOUSES EDUARDO ENCARNADO and HELEN ENCARNADO, both of legal age,

IN WITNESS WHEREOF, we have hereunto set our hands this _______________________ at

RICARDO CLARIVALL EDUARDO ENCARNADO