REPUBLIC OF THE PHILIPPINES)

CITY OF SILAY ) S.S.

x --------------------------------------- x

AFFIDAVIT OF NON-RENTAL
I, HILARY A. BANTIGUE, of legal age, Filipino, single and a resident of Corner
Mckinley Bonifacio St., Brgy. IV, Silay City, Negros Occidental, Philippines, after having been
duly sworn to in accordance with law hereby depose and say:

1. That I am the registered owner of Hilhandale Pharmacy, registered in Business

Permits and Licensing Department of Silay City. and with business address at my residential
address in Corner Mckinley Bonifacio St., Brgy. IV, Silay City, Negros Occidental, Philippines.

2. That MAGDALENA BELANDRES, is the registered co-owner of a parcel of

land covered by Transfer Certificate of Title No. T-36755 to which my said business is located.

3. I am not paying any rental fee or any lease fee for the operation of my above-
stated business at my residential premises.

4. That currently I am processing, securing all necessary license and permits for the
said Hilhandale Pharmacy, registered at Business Permits and Licensing Department of Silay
City and in any Local Government of Silay City and they require me to submit this affidavit for
compliance purposes.

5. That I am executing this affidavit to attest to the truth of the foregoing facts to the
best of my own knowledge and based on authentic records at hand and for the purpose of
declaring that I am not paying any rental fee.

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

, in the City of Silay, Negros Occidental, Philippines.

CONFORME/ATTESTED BY:

HILARY A. BANTIGUE
MAGDALENA BELANDRES Affiant

SUBSCRIBED AND SWORN TO before me this day of

in the City of Silay, Negros Occidental, Philippines, affiants exhibited to
me their I.D 0090645 issued by PRC, Bacolod City, Negros Occidental, and I.D CRN-021-1107-
6536-0 issued by UMID/SSS, Bacolod City, Negros Occidental, bearing her photograph and
signature.

WITNESS MY HAND AND SEAL on the date and place above-written.

Doc No. ;
Page No. ;
Book No. ;
Series of 2023.