REPUBLIC OF THE PHILIPPINES )

PROVINCE OF PANGASINAN ) S.S.

CITY/MUN. OF )

AFFIDAVIT

I, EUGENE A. ZULUETA, of legal age, Filipino citizen, married to MYLINE F.

ZULUETA, and a resident of Chico Street, Golden Mapandan, Pangasinan, after having been
duly sworn to in accordance with law, do hereby depose and state;

1. That we are the owner/developer of the subdivided lots located at Brgy. Loyan,
Mapandan, Pangasinan, covered by Transfer Certificate of Title Nos. 026-
2021003624 and 026-2021003625 containing an area of Fourteen Thousand Nine
Hundred Thirty-Four (14,934) square meters, more or less.

2. That the above-mentioned property is the subject of application for Registration and
License to Sell for the proposed is the subdivision now pending with the Department
of Human Settlements and Urban Development (DHSUD).

3. That to the best of my knowledge, said land is free from all liens and encumbrances.

4. That in the event said property shall be mortgaged to any person natural or judicial,
we hereby undertake to nullify and secure approval of the DHSUD prior to such
mortgage.

5. That we are executing this Affidavit to attest the veracity of the above-mentioned
facts thereby satisfying the requirements of the DHSUD relative to our application for
Registration and License to Sell for the above-mentioned project.

Affiants further says nothing

IN WITNESS WHEREOF, We have hereunto set our hands and affixed our signatures
this _____ day of _______________, 2023 at ____________, Pangasinan.

EUGENE A. ZULUETA MYLINE F. ZULUETA

Affiant Affiant
ID No. ID No.

SUBSCRIBED AND SWORN to before me this _____ day of _______________, 2023

at ____________, Pangasinan, affiant exhibiting to me their Competent Evidence of Identity
indicated below their typewritten/printed name.

NOTARY PUBLIC

Doc. No. ____;

Page No.____;
Book No. ____;
Series of 20___;