REPUBLIC OF THE PHILIPPINES )

Makati City ) SS.

AFFIDAVIT

I, ________________, of legal age, single, presently residing at

________________________, under oath, state:

1. That I am the wife of ___________________;

2. That we were married at ______________ on ____________;

3. That sometime ____________ we separated;

4. That since ________ I have no communication with my estranged

husband;

5. That I intend to sell a property in ____________under Transfer

Certificate of Title No. ____________;

6. That efforts were made to locate his present whereabouts to seek

his conformity for the sale of the above mentioned property but to
no avail;

7. That I am executing this Affidavit to attest to the truth of the

foregoing facts.

IN WITNESS WHEREOF, I hereunto affix my signature this ______ th day of

_______________ 2017 at Makati City.

_________________
Affiant

SUBSCRIBED AND SWORN to before me this ________ th day of

________________ 2017 at _____________, Affiant exhibiting to me her
________________ issued at by the __________________________.

NOTARY PUBLIC
Doc No. ________;
Page No. _______ ;
Book No. _______;
Series of 2017