REPUBLIC OF THE PHILIPPINES)

TARLAC CITY )S.S.

AFFIDAVIT

I, JOANA LUCERO GROMIO, of legal age, single, Filipino citizen, resident of Brgy.
Sinigpit, Paniqui, Tarlac, after been duly sworn to in accordance with law, do hereby depose and
state that:

1. I am the buyer of a certain parcel of land situated in the Barrio of Balaoang, Municipality
of Paniqui, Province of Tarlac, and embraced by Transfer Certificate of Title No. O—
19137 and O-18902. Copies of the subject title and the Deed of Absolute Sale are hereto
attached for reference;

2. That the said property that I had acquired shall be named after SPOUSES
_________________________________ and ______________________________, both
of legal age, Filipino citizens, and residents of __________________________________;

3. That just in case I die, ROWENA VALDEZ, of legal age, Filipino citizen, and a resident
of Paniqui, Tarlac, and a relative of the said SPOUSES
___________________________________________________________ shall manage
and possess the said subject title for safe keeping;

4. That I had hired a lawyer/law firm to facilitate and supervise the Issuance Second
Owner’s Copy and any and all titling processes of the said title.

5. I shall then agree to sign any and all documents required for the transfer of the subject lot
title unto the said real buyer;

6. I am executing this affidavit to attest to the truth of the foregoing statements and for all
legal intents and purposes it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this

________________________ at Tarlac City, Philippines.

JOANA LUCERO GROMIO

Affiant

SUBSCRIBED AND SWORN to before me this ______________________ day of

__________________________________ at Tarlac City, Philippines.

Doc No. _________ ;

Page No._________ ;
Book No. ________ ;
Series of 2021