REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF LOSS OF PASSPORT

I, FRANCO N. CAWILI, of legal age, Filipino citizen, single and with residence
and postal address at #81 South Drive, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1. That I was issued by the Department of Foreign Affairs a passport sometime
on 2012 which shall expire on 2017;
2. That I have always kept the same inside the topmost part of my bedside table
drawer;
3. However, when I looked for it on October 25, 2015 as I intend to spend the
upcoming Christmas holiday in Brussels, I could not find it ;
4. That diligent efforts were exerted to recover the said passport but the same
proved futile and fruitless;
5. That the said passport was lost in the manner stated above and was not
confiscated nor cancelled by the issuing agency or other agencies for violation
of any of its terms and conditions, laws, rules and regulations;
6. That I am now executing this affidavit to attest to the veracity of the foregoing
narration for securing a replacement of the said lost passport and for all legal
intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February
2016, in the City of Baguio, Philippines.
_______________________
FRANCO N. CAWILI
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 3rd day of February 2016, by Franco N. Cawili, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00521731 issued on January
9, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
2;
Page No. 1;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF LOSS OF IDENTIFICATION CARD

I, MARIA M. CRESENCIA, of legal age, Filipino citizen, single and with residence
and postal address at #22 Outlook Drive, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1.

That I was issued by the City Government of Baguio an identification card

sometime on 2012;

2.

That I have always kept the same inside my wallet;

3.

However, when I looked for it on January 25, 2016 as I intend to apply for work
elsewhere, I could not find it ;

4.

That diligent efforts were exerted to recover the said ID but the same proved futile and
fruitless;

5.

That the said ID was lost in the manner stated above and was not confiscated nor
cancelled by the issuing agency or other agencies for violation of any of its terms and
conditions, laws, rules and regulations;

6.

That I am now executing this affidavit to attest to the veracity of the foregoing narration
for securing a replacement of the said lost ID and for all legal intents and purposes it
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February
2016, in the City of Baguio, Philippines.
_______________________
MARIA M. CRESENCIA
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 3rd day of February 2016, by Maria M. Cresencia, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 80521731 issued on January
19, 2016 in Baguio, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
1;
Page No. 1;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF LOSS OF AUTOMATED TELLER MACHINE CARD

I, MARIE M. BAUTISTA, of legal age, Filipino citizen, single and with residence
and postal address at #92 Private Road, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1. That I was issued by the Bank of the Philippine Islands (BPI) an automated
teller machine (ATM) card sometime on 2012;
2. That I have always kept the same inside my wallet;
3. However, when I looked for it on January 25, 2016 as I intend to withdraw
for the payment of my tuition, I could not find it ;
4. That diligent efforts were exerted to recover the said ATM but the same
proved futile and fruitless;
5. That the said ATM was lost in the manner stated above and was not
confiscated nor cancelled by the issuing agency or other agencies for
violation of any of its terms and conditions, laws, rules and regulations;
6. That I am now executing this affidavit to attest to the veracity of the
foregoing narration for securing a replacement of the said lost ATM and for
all legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February
2016, in the City of Baguio, Philippines.
_______________________
MARIE M. BAUTISTA
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 3rd day of February 2016, by Maria M. Bautista, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00321731 issued on January
4, 2016 in Baguio, and that she is the same person who personally signed the foregoing
affidavit before me and acknowledged that she executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
3;
Page No. 1;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF EXPLANATION
I, MARCO N. ANTON, of legal age, Filipino citizen, single and with residence and
postal address at #1 Upper QM, Baguio City, having been duly sworn in accordance
with law, do hereby depose and state:
1. That I was issued by the Department of Foreign Affairs a passport
sometime on 2012 which shall expire on 2017;
2. That I have always kept the same inside the topmost part of my bedside
table drawer;
3. However, when I looked for it on October 25, 2015 as I intend to spend the
upcoming Christmas holiday in Brussels, I could not find it ;
4. That diligent efforts were exerted to recover the said passport but the same
was found destroyed in the cage of our dog;
5. That the said passport was lost in the manner stated above and was
mutilated by our dog;
6. That I am now executing this affidavit to attest to the veracity of the
foregoing narration for securing a replacement of the said passport and for
all legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
MARCO N. ANTON
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Marco N. Anton, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00521232 issued on January
29, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
4;
Page No. 1;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF ACCIDENT
I, RODRIGO V. DUMDUM, of legal age, Filipino citizen, single and with residence
and postal address at #12 Upper Rock Quarry, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1. That I am currently employed as a truck driver of hauling one (1) trucking
company which has an existing service contract with Orient Freight
International, Inc., also known as OFII for brevity;
2. That OFII is a domestic company which is generally engaged in logistics
and forwarding business;
3. That on January 5, 2016, at about 2:30 A.M., I was carefully traversing the
Marcos Highway, heading to Baguio City while driving a cargo truck loaded
with several crates of fresh mangoes for delivery ;
4. That apparently however, one of the vehicles on the other side of the
highway has overtaken the trailer ahead of it;
5. That considering the condition of the road, the overtaking vehicle smashed
off a piled-up soil on the rightmost side of the road where I was traversing,
thereby causing it to crash and spread out several rock particles on the
middle of the highway;
6. That the overtaking vehicle has successfully passed the scenario without
any untoward incident on its part, whereas, in my case, it brought my truck
to an abnormal state;
7. That the truck I was driving has lost its break and it even took me
approximately one (1) kilometer distance before I managed to maneuver
the truck to stop;
8. That unfortunately, it went off-balance and collapsed on the right side,
causing the cargoes to roll out of the truck;
9. That with the use of my mobile phone, I managed to inform my supervisor,
Mr. Andres Bonifacio about the incident;
10. That through a trail of information, Mr. Alex Batulan, Claims Officer of
Aboitiz 2GO, came over along on the area with some of the rescue team at
about 6:00 PM of the following day;
11. That unfortunately, no sketch was made by the police;
12. That this affidavit is executed to attest to the truth of the above-narrated
facts and to further testify to the veracity of the foregoing statement.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
RODRIGO V. DUMDUM
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Rodrigo V. Dumdum, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00302232 issued on February
2, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
5;
Page No. 1;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT FOR MECHANICS LIEN

I, MARIO A. DIAZ, of legal age, Filipino citizen, single and with residence and
postal address at #12 Lower QM, Baguio City, having been duly sworn in accordance
with law, do hereby depose and state:
1. That the lien claimant furnished certain material and performed certain
labor or work in furtherance of improvements located on the land
hereinafter described, pursuant to a certain contract, with the owner, Ms.
Grace L. Salinas;
2. That the first of the labor was performed and material was furnished on the
fifth day of January 2016;
3. That the last of the labor or work was performed on the second day of
February ;
4. That there is justly and truly due the lien claimant therefore from the owner,
as the case may be, over and above all legal setoffs, the sum of one
hundred thousand pesos (P100,000.00);
5. That for which amount, the lien claimant, claims a lien on the land of the
owner, which premises are described as follows: #89 Bakakeng Central,
Baguio City;
6. That I am now executing this affidavit to attest to the veracity of the
foregoing narration for securing a replacement of the said passport and for
all legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
MARIO A. DIAZ
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Mario A. Diaz, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00542232 issued on January
6, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
6;
Page No. 2;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT FOR CHANGE OF COLOR OF MOTOR VEHICLE

I, SASHA H. GREY, of legal age, Filipino citizen, single and with residence and
postal address at #18 Lower Rock Quarry, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1. I am the owner of a certain registered motor vehicle, which I inherited from my
deceased father through intestate succession, with the particular description as
follows, to wit:
MAKE: Honda
BODY: Sedan
SERIES: Civic
MODEL: 1998
PLATE NO.: UTS 101
Serial/Chassis No.: US15- 2B3509
MV FILE No.: 2477- 33438
2. I recently changed the color of the said motor vehicle from color blue to pink.
3. I therefore have executed this Affidavit to cause the necessary changes in the
registration of the above- mentioned vehicle in the Land Transportation Office, to
attest the truth I mentioned herein and for whatever legal purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
SASHA H. GREY
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Sasha H. Grey, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00267232 issued on January
16, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No.
7;
Page No. 2;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT FOR CHANGE OF ENGINE OF MOTOR VEHICLE

I, CHRISTIAN H. GREY, of legal age, Filipino citizen, single and with residence
and postal address at #96 Andres Bonifacio, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1. That I am the owner of a certain registered motor vehicle, which I inherited from
my deceased father through intestate succession, with the particular description
as follows, to wit:
MAKE: Honda
BODY: Sedan
SERIES: Civic
MODEL: 2000
PLATE NO.: UAS 231
Serial/Chassis No.: US24- 1B5789
MV FILE No.: 2477- 33438
2. That I recently changed the engine of the motor vehicle;
3. That I therefore have executed this Affidavit to cause the necessary changes in
the registration of the above- mentioned vehicle in the Land Transportation
Office, to attest the truth I mentioned herein and for whatever legal purposes it
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
CHRISTIAN H. GREY
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Christian H. Grey, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00279652 issued on January
25, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No.
8;
Page No. 2;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF DECLARATION OF OWNERSHIP

I, ELIZABETH O. CLEMENTE, of legal age, Filipino citizen, single, Manager of
Rubinzons Corporation and with residence and postal address at #7 Magsaysay
Avenue, Baguio City, having been duly sworn in accordance with law, do hereby depose
and state:
1. That said Corporation is the owner of certain parcel of land, more particularly
described as follows:
TCT No. T-2222
A PARCEL OF LAND (Lot 32 of the consolidation subdivision plan (LRC) Pcs5141, being a portion of the consolidation of Lots 1 and 2, Psu-112287 Amd.,
LRC (GLRO) Rec. No. N-17511), situated in the Dist. Of Concepcion, City of Sta.
Rosa, Laguna, Island of Luzon. Bounded on the NE., points 3 to 6, by Lot 85;
on the S., points 6 to 1 by Lot 30; on the SW., points 1 to 2, by Lot 31; and on the
N., points 2 to 3 by Lot 35, all of the consolidation-subdivision plan. Beginning at
a point marked "1" on plan, being N. 51 deg. 36' E., 1321.76 m. from B.L.L.M.
No.1, Sta. Rosa, Laguna
2. That the said aforementioned Transfer Certificate of Title over said property
includes and contains all the permanent improvements and buildings located and
situated thereon;
3. That I execute this Affidavit to attest and declare the truth of the foregoing facts
and for whatever legal purposes that this Affidavit may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
ELIZABETH O. CLEMENTE
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Elizabeth O. Clemente, who has satisfactorily proven
her identity to me through her Community Tax Certificate No. 00284356 issued on
January 10, 2016 in Baguio City, and that she is the same person who personally
signed the foregoing affidavit before me and acknowledged that she executed the
same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No.
9;
Page No. 2;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,
TIN 428-986-655

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF SERVICE
I, ELLEN A. ADARNA, of legal age, Filipino citizen, single, and with
residence and postal address at #12 Petersville Subdivision, Baguio City,
having been duly sworn in accordance with law, do hereby depose and
state:
1. That I am the wife of RAPHAEL ENRIQUE V. CORONADO;
2. That on 26 July 2013, Rica Kaye O. Lomibao, President of
XHamsters Corporation, personally went to the business office of my
husband to talk with him and settle her financial obligations;
3. That as my husband was not around during that time, I personally
handed to Rica Kaye O. Lomibao a demand letter dated sometime in
the month of June 2012 as per my husbands instruction;
4. That Rica Kaye O. Lomibao refused to receive the demand letter and
told me instead that she will just talk and settle her obligation to my
husband personally;
5. That I am executing this affidavit in all good faith and to attest the
truth of the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
ELLEN A. ADARNA
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Ellen A. Adarna, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00258646 issued on January
24, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No. 10;

Page No. 2;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267,

01-15-19

TIN 428-986-655

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF PUBLICATION
I, DIANA P. ZUBIRI, of legal age, Filipino citizen, single, and with
residence and postal address at #2 Richgate Subdivision, Baguio City,
having been duly sworn in accordance with law, do hereby depose and
state:
1. That I am the Advertising Director of BDSM Inc. that publishes
Tiktik Magazine, a newspaper of general circulation in the
Philippines, printed and published in Port Area, Quezon City;
2. That a NOTICE OF PUBLICATION- ORDER AND SUMMONS (by
publication) Raphael Enrique V. Coronado, petitioner, -versusEllen A. Adarna, respondent, Civil Case no. C-QTZ-24-25285-D
for: Declaration of Nullity of Marriage, RTC, National Capital
Judicial Region, Branch 113, Pasay City;
3. That a printed copy of which is hereto attached, was published in
the said newspaper on January 4, 2016;
4. That this affidavit is executed to attest to the truth of the abovenarrated facts and to further testify to the veracity of the foregoing
statement.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
DIANA P. ZUBIRI
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Diana P. Zubiri, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00264832 issued on January
7, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No. 11;

Page No. 3;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)

MCLE

Compliance No.
TIN 428-986-655

II-0002267,

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

JOINT AFFIDAVIT OF COHABITATION

We, Benjamin A. Bualat Jr. of legal age, Filipino, Ivy Joy G. Ombayan, of legal age,
Filipino, both are residents of #14 Emerald St. Ecoland Subdivision, after having been sworn to in
accordance with law hereby depose and say that:
1. We became sweethearts on the year 2010;
2. On November 28, 2010, we started to live and treat each other as husband and wife living
in one roof up to the present without the benefit of marriage;
3. During our cohabitation, we do not engage in other relationship with the opposite sex;
4. Our cohabitation is continuous and uninterrupted from November 2010 up to the present
which is more than five (5) years;
5. We have two children namely: Louie Jay O. Bualat and Daryn Nicole O. Bualat. Louie Jay
is three (3) years old and Daryn Nicole is one (1)year old;
6. We planned to get married on January 2017 for our interest and for our children as well so
that they will be legitimated;
7. We are executing this affidavit to attest the truth of the foregoing and to inform the
authorities concerned to exempt us from obtaining a marriage license.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
BENJAMIN A. BUALAT JR.
Affiant

_______________________
IVY JOY G. OMBAYAN
Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Benjamin A. Bualat and Ivy Joy G. Ombayan, who has
satisfactorily proven their identities to me through their Community Tax Certificate No.
00265482 and 00265492, respectively both issued on January 17, 2016 in Baguio City,
and that they are the same person who personally signed the foregoing affidavit before
me and acknowledged that they executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 12;

Page No. 3;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)

MCLE

Compliance No.
TIN 428-986-655

II-0002267,

01-15-19

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF CO-OWNERSHIP
I, LEGARDA O. MANUEL, of legal age, Filipino citizen, single, son of John O.
Manual aged eighty years old, and with residence and postal address at #5 Richwood
Subdivision, Baguio City, having been duly sworn in accordance with law, do hereby
depose and state:
1. That there is an ancestral property under Survey No. 4567, Sub Div No. 5478
in Imelda Village barangay measuring 100 Ha in the name of John O. Manuel
as owner;
2. That John O. Manuel has expired on 28 December 2015 and has left behind
Legarda O. Manuel, his son, as the heir and that the inheritance and mutation
proceedings are in progress with the authorities;
3. That out of 100 ha of property, 40 ha is cultivated by me independently for the
last 30 years and in consent of other co-owners;
4. That this affidavit is executed for proving my co-ownership and possessions
for development of the said portion of land to avail financial assistance from
the Department of Agriculture;
5. That the facts contained hereinabove in paragraphs 1 to 4 are true to the best
of my knowledge.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
LEGARDA O. MANUEL
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Legarda O. Manuel, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00248521 issued on January
14, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 13;

Page No. 3;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)

MCLE Compliance No. II-0002267, 01-15-19

TIN 428-986-655
REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF CONSENT FOR TRAVEL OF A MINOR ABROAD

We, MARIA GABRIELA C. DOROTAN and BERNICE MICHELLE N. DOROTAN, married to

each other, of legal ages, Filipinos, with residence and postal address at #31-G Baltazar, Brgy.
Gibraltar, Mines View, Baguio City, Philippines, and with Taxpayer Identification Nos. (T.I.N.) 121244-588 and 114-389-911, respectively, after having been duly sworn in accordance with law, do
hereby depose and state:

1.

That we are the parents of MENCHIE N. DOROTAN, who is 10 years old and a
citizen of the Republic of the Philippines and a holder of valid Philippine Passport with No.
NN3311221 and who is going for a trip abroad specifically to Washington DC, USA this
February 15, 2016;

2.

That we are giving our full consent to our said daughter to travel abroad or
specifically to Washington DC, USA;

3.

That for this purpose, we have sufficient and adequate financial capacity to
support and defray the said travel and do hereby undertake to finance her trip abroad from
the application fees, airline tickets, board and lodging, pocket money and such other
expenses that she may incur so that she would neither be a burden to the state nor at their
place of destination at any time during his trip abroad;

4.

That there is no criminal case pending in court against her nor has she been
charged of subversion, rebellion, insurrection or any crime or offense involving moral
turpitude in any court of the Philippines;

5.

That further, MENCHIE N. DOROTAN will be accompanied or escorted by her

doctor, Atty. LEISLY KEITH CASTILLO in her travel abroad;

6.

That we are hereby giving our full consent to said ATTY. LESLY KEITH
CASTILLO to accompany or escort MENCHIE N. DOROTAN in her travel abroad; and

7.

That we are executing this affidavit to declare the truth of the foregoing facts
and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this 4TH day of February 2016 in
the City of Baguio, Philippines.

__________________________

___________________________

EDWARD JACOB C. NAVARRO

ISABELLA MARIE S. NAVARRO

Affiant

Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Edward Jacob C. Navarro and Isabella Marie S.
Navarro, who has satisfactorily proven their identities to me through their Community
Tax Certificate No. 00265522 and 00265532, respectively both issued on January 7,
2016 in Baguio City, and that they are the same person who personally signed the
foregoing affidavit before me and acknowledged that they executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 14;

Page No. 3;
Book No.OF THE
I; PHILIPPINES}
REPUBLIC
Series
2016
DONE:
INof
THE
CITY OF BAGUIO } S.S.

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

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

AFFIDAVIT OF DESISTANCE
I, CHRISTIME H. EBREO, single, of legal age, Filipino citizen, with residence and postal address
at #35 Cabinet Hill, Baguio City, after having been duly sworn in accordance with law, do hereby depose
and state:
1. That I am the Private Complainant in Criminal Case No. 35667-R for violation of B.P. Blg. 22
otherwise known as the Bouncing Checks Law now pending before the Regional Trial Court,
Baguio City, Branch 3;
2. That the accused DIANA C. DY has settled his obligations with me to my full satisfaction;
3. That due to the aforementioned reason, I freely and voluntarily pray for the FINAL DISMISSAL of
the case against Diana C. Dy;
4. That I am no longer interested to pursue the case against said Diana C. Dy;
5. That I am now requesting the Office of the City Prosecutor of Baguio City and the Honorable
Court, Regional Trial Court, Branch 3 of Baguio City to have the case withdrawn against Diana
C. Dy;
6. That I am executing this Affidavit of Desistance to attest to the truth of all the foregoing facts, as
well as, to withdraw my complaint against Diana C. Dy, and ultimately have the case against him
be dismissed.

IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in
the City of Baguio, Philippines.
_______________________
CHRISTIME H. EBREO
Affiant / Private Complainant
Passport No. GG8553422

CERTIFICATION
This is to certify that I have personally examined the affiant and I am convinced that he
voluntarily executed his statement and understood the contents thereto.
_____________
William Vargas
Public Prosecutor

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Christime H. Ebreo, who has satisfactorily proven his
identity to me through his Community Tax Certificate No. 00248825 issued on January
8, 2016 in Baguio City, and that he is the same person who personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 15;

Page No. 3;
Book No.
I;
REPUBLIC
OF
Series of 2016 THE PHILIPPINES}

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF DISCREPANCY
I, VICTORIA ANGUES-LANGAOAN, of legal age, married, Filipino citizen, and a
resident of 410 Central Guisad, Baguio City, Philippines, having been duly sworn in accordance
with law, do hereby depose and state:
1. I was born to spouses Ricardo A. Angues and Dulnuan D. Barcanao on 16 March 1978
at Baguio General Hospital, Baguio City, Philippines;
2. Since childhood I have been using Victoria Barcanao Angguis as my complete name in
all my transactions;
3. Recently, however, when I secured a copy of certificate of live birth from the National
Statistics Office I was surprised to discover that my complete name entered therein is
Baby Girl Barcanao Angues instead of Victoria Barcanao Angguis;
4. The erroneous entry of my given name Baby Girl and the erroneous use of my family
name Angguis instead of Angues were due to inadvertence and was never meant to hide
my true identity or to evade any obligations;
5. The names Victoria Barcanao Angguis and Baby Girl Barcanao Angues refers to one
and the same person;
6. Finally, I am executing this affidavit to attest to the veracity and truthfulness of the
foregoing declarations and for all intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
________________________
VICTORIA ANGUES-LANGAOAN
Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Victoria Angues-Langaoan, who has satisfactorily
proven his identity to me through his Community Tax Certificate No. 00248456 issued
on January 18, 2016 in Baguio City, and that he is the same person who personally
signed the foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 16;

Page No. 4;
Book No. OFI;THE PHILIPPINES}
REPUBLIC
SeriesINofTHE
2016CITY OF BAGUIO } S.S.
DONE:
x ------------------------------------------- x

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

AFFIDAVIT OF BIRTH BY TWO DISINTERESTED PERSONS

WE, ALFREDO L. BALLEBER and ARIA NADINE CONCEPCION V. BALIGO, both
Filipinos, of legal ages, both married, and presently residing at 55C Burgundy Lane, Rainbow
Hills Subdivision, Fairview, Baguio City and at #2 La Cheza Rd., Irisan, Baguio City,
respectively, both after having been duly sworn in accordance with law, do hereby depose and
say:
1. That we personally know CHRISTIE JOY G. BACAL of #7 Badihoy St., Guisad, Baguio
City, being acquaintance for a long period of time;
2. That she is a PAG-IBIG Fund member with an application for Provident Benefits with the
Fund;
3. That the said application is required to be accompanied by a copy of the applicants birth
certificate, however, no record can be obtained, as shown by the attached Certification
of Non-Availability of Birth Record from the National Statistics Office (NSO);
4. That we certify that she was born at Baguio General Hospital, Baguio City Philippines,
on the 14th day of February in the year 1977 ;
5. That she has been using the said birth date in all her documents and transactions,
including her education and employment records;
6. That we are not related by affinity or consanguinity to the above mentioned person; and
7. That we are executing this affidavit to attest to the truth of the foregoing facts for record
and references purposes.

IN WITNESS WHEREOF, we have hereunto set our hands this 4 th day of February 2016, at
Baguio City, Philippines.
___________________
____________________
ALFREDO L. BALLEBER
ARIA NADINE CONCEPCION V. BALIGO
Affiant
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 4th
day of February 2016, by Alfredo L. Balleber and Aria Nadine Concepcion V. Baligo, who has
satisfactorily proven their identities to me through their Community Tax Certificate No. 00265252
and 00265262, respectively both issued on January 13, 2016 in Baguio City, and that they are
the same person who personally signed the foregoing affidavit before me and acknowledged
that they executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No. 17;

Page No. 4;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
X ======================= X

SUPPLEMENTAL AFFIDAVIT
I, JANET LEO-THOMAS, of legal age, Filipino citizen, and residing at
Kanluran, Barlig, Mt. Province, under oath, state that:
1. I was born on September 09, 1960 in Baguio City;
2. My parents are MIKE C. LEO and IRENE Q. DAGOL who were married on
September 24, 1954 at Sablan, Benguet;
3. Recently, I secured a copy of my Certificate of Live Birth from the Office of
the Civil Registrar of Baguio City and I discovered that my name was registered as
BABY GIRL D. LEO; and the same is true when I secured a copy of my Certificate of
Live Birth from the National Statistics Office (NSO);
4. As long as I can recall, I have been using the name JANET D. LEO ever since
I entered school, and all records pertaining to me bear my name as JANET D. LEO,
and now that I am married, I carry the name JANET LEO-THOMSON;
5. I do not know of any other person named BABY GIRL D. LEO born on
September 09, 1960, whose parents are MIKE C. LEO and IRENE Q. DAGOL except
myself, and I am certain that the names BABY GIRL D. LEO and JANET D. LEO refer
to one and the same person who is no other than myself;
6. I am executing this Supplemental Affidavit to attest to the truth of the
foregoing and for all legal intents it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of
February 2016, in the City of Baguio, Philippines.

___________________________
JANET LEO-THOMSON
(JANET D. LEO a.k.a. BABY GIRL D.
LEO)

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Janet Leo-Thomson, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00252416 issued on January
27, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No. 18;

Page No. 4;
Book No.
I;
Series of 2016
REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

AFFIDAVIT OF PATERNITY
I, BONG-BONG BUGNAY BUGTONG,of legal age, married, Filipino, and a resident
of Ballay, Kabayan, Benguet, after having been duly sworn to in accordance with law,
depose and say that:
1 I am the biological father of JORDAN MADINO BUGTONG who was born on 27
December 2004 at Ballay, Kabayan, Benguet;
2 That the fact of the said birth was duly recorded with the Local Civil Registrar of
Kabayan, Benguet with Registry No. 2010-089;
3 I hereby acknowledge paternity over the said child;
4 That I hereby attest to the truthfulness of the foregoing statements and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this 4th day of February
2016 at Baguio City, Philippines.

BONG-BONG BUGNAY BUGTONG

Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Bong-bong Bugnay Bugtong, who has satisfactorily
proven his identity to me through his Community Tax Certificate No. 00252992 issued
on January 22, 2016 in Baguio City, and that he is the same person who personally
signed the foregoing affidavit before me and acknowledged that he executed the same.

NOELLE GRACE B. RILLON

Notary Public

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

Doc. No. 19;

Page No. 4;
Book No.
I;
Series of 2016
REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF LEGITIMATION
We, the spouses STANLEY GOTOHIO and JHAYNE B. USON-GOTOHIO, both of legal
age, Filipinos, with residence and postal address at #47 Quisumbing St., Trancoville, Baguio
City, Philippines, having been duly sworn in accordance with law, do hereby depose and state
that:
1. We were in an intimate relationship since December of 2008 with no impediments
barring as in marrying each other but without the benefit of marriage, we started
cohabiting as husband and wife in 2010 at Honeymoon, Baguio City;
2. Out of our relationship was born a son on March 3, 2011 whom we named NATHANAEL
AEOMER;
3. As our son was born out of wedlock, he is considered illegitimate and he bears the
family name of his mother which is USON;
4. We subsequently got married on August 22, 2012 at St. Joseph Parish Church in
Pacdal, Baguio City as evidenced by our Certificate of Marriage;
5. At the time of the birth of our child, NATHANAEL AEOMER, we possessed all the
qualifications and none of the disqualifications to marry each other;
6. As a result of our marriage, the status of our child is legitimized and as such, he shall
now bear the family name of his father which is GOTOHIO;

7. We execute this affidavit to attest to the truth of the foregoing statements and for the
purpose of causing the legitimation of the status of our child, NATHANAEL AEOMER
and for all legal intents and purposes this may well serve;
IN WITNESS WHEREOF, we hereunto set our hands this 4TH day of February 2016 in the
City of Baguio, Philippines.
________________________
STANLEY GOTOHIO
Affiant

__________________________
JHAYNE B. USON-GOTOHIO
Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio,

Philippines, this 4th day of February 2016, by Stanley Gotohio and Jhayne B. UsonGotohio, who has satisfactorily proven their identities to me through their Community
Tax Certificate No. 00265892 and 00265882, respectively both issued on January 23,
2016 in Baguio City, and that they are the same person who personally signed the
foregoing affidavit before me and acknowledged that they executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 20;

Page No. 4;
Book No.
I;
REPUBLIC OF THE PHILIPPINES}
Series of 2016
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

AFFIDAVIT OF ILLEGITIMACY
I, PHOEBE CORAZON T. HABACON, single, of legal age, Filipino citizen, with
residence and postal address at #18 Everlasting St., Upper Q.M., Baguio City, Philippines,
having been duly sworn in accordance with law, do hereby depose and state that:
1. I am the biological mother of Cherry Kaye T. Habacon, who was born on March 23
2002, at St. Paul Hospital, and who is a resident of Enrile, Cagayan. Attached hereto
and made as integral part hereof is an NSO copy of the birth certificate of my child.
2. That as appearing in the records of Office of the Civil Registrar of the Municipality of
Enrile, Province of Cagayan, Philippines, the father of the said child is Edwin G.
Pamittan, who is a Filipino citizen. The same is certified by the attached Certificate of
Live Birth of the said child.
3. That I hereby affirm and attest to the truth of the fact that the father of the abovementioned child is indeed Edwin G. Pamittan.
4. That at the time my child was born, I was not legally married to her biological father, nor
am I legally married to the said father now. Attached is a copy of a Certificate of No
Marriage and made an integral part hereof.

5. This Affidavit is being executed in order to attest to the truth of the foregoing facts and
for whatever purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in the
City of Baguio, Philippines.
______________________________
PHOEBE CORAZON T. HABACON
Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Phoebe Corazon T. Habacon, who has satisfactorily
proven her identity to me through her Community Tax Certificate No. 00252422 issued
on January 22, 2016 in Baguio City, and that she is the same person who personally
signed the foregoing affidavit before me and acknowledged that she executed the
same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 21;

Page No. 5;
Book No.
I;
Series
of
2016
REPUBLIC OF THE PHILIPPINES}

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF GUARDIANSHIP
I, LEONARDITA A. FERONEL, of legal age, Filipino citizen, widow and presently
residing at #100-B City Camp Alley Extension, Baguio City, Philippines, having been
duly sworn to in accordance with law, do hereby depose and say:
1. That I am the mother of the minor named below who have an interest in the
PAG-IBIG provident benefits of my late husband SHERWIN A. FERONEL
payable by the PAG-IBIG Fund;
NAME OF MINOR

DATE OF BIRTH

KIMBERLY FERONEL

September 23, 2010

AGE
2

2. That I am the guardian of the above-named minor;

3. That the said minor is under my sole care and custody;
4. That I am competent to receive in behalf of the said minor any amounts due her;
and

5. That I am not an imbecile, insane, a vagrant or a vicious person or a habitual

drunkard or a habitual criminal, and have not abandoned, neglected or refused
to support said minor or caused her to commit offenses against the law.
IN WITNESS WHEREOF, I have hereunto set my hand this 27TH day of June 2014,
at Baguio City, Philippines.
_______________________
LEONARDITA A. FERONEL
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Leonardita A. Feronel, who has satisfactorily proven
her identity to me through her Community Tax Certificate No. 00253562 issued on
January 28, 2016 in Baguio City, and that she is the same person who personally
signed the foregoing affidavit before me and acknowledged that she executed the
same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 22;

Page No. 5;
Book No.
I;
REPUBLIC
THE PHILIPPINES}
Series ofOF
2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF SUPPORT
I, DOMINIC T. FUENTEBELLA, married to LETTY CASSIE R. FUENTEBELLA, of legal age, former
Filipino citizen, now a U.S. citizen, with permanent address at 335 Lexington Avenue, New York, USA and
temporary Philippine address at # 28 Quezon Hill, Baguio City, Philippines, after having been sworn to in
accordance with law, do hereby depose and state that:
1.

I am the brother of MIA LORIE T. FUENTEBELLA, with pending application for Student Visa with the
Department of Immigration and Citizenship of Canada;

2.

I am willing to extend my whole hearted support for her studies in Canada, I being her brother and
have the financial capability to provide all her needs during the period of her studies;

3.

At present, I am maintaining a bank account with BDO Banking Corporation located in Session Road
Branch in Baguio City, Philippines under passbook savings account number 18-14-57937-4 and Time
Deposit Account Number COD 789981 with an amount of Two Million Five Hundred Twenty One
Thousand Seven Hundred Fifty Pesos and Twenty-eight centavos (Php2,521,750.28) where I can
source out all needed expenses that my sister may use during her studies should her application be
granted;

4.

In relation to the support, I have authorized MIA LORIE T. FUENTEBELLA to withdraw any amount
from my bank account which she needs during the period of her studies. Attached to this affidavit is a
copy of the said authorization marked as annex A to form an integral part hereof;

5.

Aside from my savings mentioned in paragraph 3 of this affidavit, my other source of income where I
can source out additional financial support to MIA LORIE T. FUENTEBELLA are from my salaries and
earnings in the United States;

6.

I shall provide any other support that she may need other than money should it be necessary or as
maybe further required by the Canadian Government during the period of her studies in said country;

7.

I am executing this affidavit to attest the truth of the foregoing facts and to support the application of
MIA LORIE T. FUENTEBELLA, my sister, for the issuance of her student visa and for all legal intents
this affidavit may lawfully serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in Baguio City,
Philippines.
___________________________
DOMINIC T. FUENTEBELLA
Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Dominic T. Fuentebella, who has satisfactorily proven
his identity to me through his Community Tax Certificate No. 00254282 issued on
January 18, 2016 in Baguio City, and that he is the same person who personally signed
the foregoing affidavit before me and acknowledged that he executed the same.
NOELLE GRACE B. RILLON
Notary Public
Until December 31, 2017
City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

Doc. No. 23;

Page No. 5;
Book No.
I;
Series of 2016
REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF SELF-ADJUDICATION
I, Maychelle S. Ablog, of legal age, Filipino, single and a resident of No. 115 Maria Basa, Pacdal, Baguio
City, Philippines, after having been duly sworn in accordance with law, do hereby depose and say:
1.
2.
3.

That I am the only son of Peter B. Ablog who died intestate in the City of Baguio, on September 3, 2011 as
evidenced by Death Certificate issued by the Civil Registrar of Baguio, hereto attached as ANNEX A and
made an integral part of this Affidavit;
That said deceased left an estate consisting of a parcel of land measuring ONE THOUSAND (1,000)
SQUARE METERS, located at Mary Hills Road, Loakan Proper, Baguio City covered by Transfer Certificate
Title No. CC-19876 of the Registry of Deeds of Baguio City;
That the said parcel of land is more particularly described as follows to wit;
LOT 21 (LRC) CC-19876
A parcel of land (Lot 21 of Subdivision plan LRC) CC-19876 being a portion of
the parcel of land described on TS-V-789D, l\LRC Rec. No. TS sales Pat.) situated in
Res. Sec. City of Baguio, island of Luzon, Philippines. Bounded on the N.E point 5 to 7 y
Subdivision Road (1, 000 m. Wide); on the SW., points 5 to 1 by Lot 2, of the Subdivision
Plan; and on the NW., points 1 to 2 by Lot 9, Block 2. Beginning at point marked I on
plan, being N 43 deg 21 deg E, 321.70 m. from the main gate.
thence N 25 deg. 00E, 40.00 m to point 2;
thence E 23 deg. 00E, 32.00 m to point 3;
thence N 52 deg. 13E, 11.00 m to point 4;
thence S 75 deg. 00E, 456.00 m to point 5;
thence N 53 deg. 00E, 13.00 m to point of beginning;
containing an area of ONE THOUSAND 1000 SQUARE METERS, more or less. All
points referred to are indicated on the Plan and marked on the ground as follows; Points
1 to 4 by OLD points and the rest by PS cyl conc. Mons. 100 x 213 cm; bearings true;

date of Original Survey, April 2 1982 and that of Subdivision Survey executed by Gilbert
M. Gunnawa, a Geodetic Engineer on April 12, 1990.
4.
5.

That the said deceased left no debts nor any LAST WILL AND TESTAMENT;
That pursuant to Rule 74, Section 1 of the Rules of Court, I hereby adjudicate unto myself the above
described Real Estate by means of this Affidavit and hereby files the same with the Register of Deeds of
Baguio City with the request that said adjudication be made effective without the judicial proceeding as
prescribed by the aforementioned Rules of Court.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February 2016 at Baguio City,
Philippines.
____________________
MAYCHELLE S. ABLOG
Affiant
TIN: 842-596-319

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Maychelle S. Ablog, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00258882 issued on January
7, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 24;

Page No. 5;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x
AFFIDAVIT OF EMPLOYMENT
I, Clarita G. Batulan, of legal age, Filipino, single and a resident of
No. 9 Maria Basa, Pacdal, Baguio City, Philippines, after having been duly
sworn in accordance with law, do hereby depose and say:
1. That I am employed by the City Government of Baguio, specifically at
the City Assessors Office with the position of Tax Mapper II since
January 2014 to the present;
2. That enclosed is my original certificate of employment issued by my
employer; and
3. This Affidavit is being executed in order to attest to the truth of the
foregoing facts and not for the purpose of fraud but in connection with
my loan application in the Philippines.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of

February 2016 at Baguio City, Philippines.
____________________
CLARITA G. BATULAN
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio,
Philippines, this 4th day of February 2016, by Clarita G. Batulan, who has
satisfactorily proven her identity to me through her Community Tax
Certificate No. 00257892 issued on January 30, 2016 in Baguio City, and
that she is the same person who personally signed the foregoing affidavit
before me and acknowledged that she executed the same.
NOELLE GRACE B. RILLON
Notary Public
Until December 31, 2017
City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

Doc. No. 25;

Page No. 5;
Book No.
I;
Series of 2016
REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF NO PENDING CASE

I, LIEDA B. ABELLERA, Filipino, of legal age, married and a resident
of Kabayan, Benguet, after having been duly sworn in accordance with law,
hereby depose and say that:
1 I am a former revenue collection clerk of the Local Government
Unit of Kabayan, Benguet;
2 There is no pending criminal or administrative case filed against
me in any court or other office including at the barangay level;
3 I filed my resignation on December 31, 2015, effective on the
same day;

4 This affidavit is being executed in support of my claim for

benefits from the LGU-Kabayan, Benguet and for any legal
intents and purposes this affidavit may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
4 day of February 2016 at Baguio City, Philippines.
th

LIEDA B. ABELLERA
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Leida B. Abellera, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00242822 issued on January
31, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 26;

Page No. 6;
Book No.
I;
Series of 2016
REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

AFFIDAVIT OF NON-OPERATION OF BUSINESS

I, JENNY LISA M. BALAWAN, single, of legal age, Filipino citizen, and a resident of 88F
Lower Brookside, Baguio City, Philippines, after having been duly sworn to in accordance with
law, do hereby depose and state:
1. That I am the President and Chief Executive Officer of Field Crest Real Estate Planning
and Development, Inc., a corporation duly organized and existing under the laws of the
Philippines, with principal office at Unit 4F,4th Floor Yorkshire Building, Legarda Rd.,
Baguio City, Philippines;
2. That said corporation was incorporated on June 14, 2009 and acquired by the
undersigned with the purchase of its corporate property in the above address sometime
in July 2010 but has not yet commenced its operations in view of the slump in the real
estate industry in the country;
3. That the stockholders and directors of the corporation are contemplating on reviving its
operations in the near future when the opportune time comes;

4. 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 reportorial requirements of the
Securities and Exchange Commission.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in the
City of Baguio, Philippines.
______________________
JENNY LISA M. BALAWAN
Affiant
TIN: 443-511-214

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,

this 4th day of February 2016, by Jenny Lisa M. Balawan, who has satisfactorily proven
her identity to me through her Community Tax Certificate No. 00252622 issued on
January 14, 2016 in Baguio City, and that she is the same person who personally
signed the foregoing affidavit before me and acknowledged that she executed the
same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 27;

Page No. 6;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF TRANSFEROR
I, LUCIE ANTONNETTE D. LUCERO, single, of legal age, Filipino citizen and a
resident of #78-D Guisad, Surong Ext., Baguio City, Philippines, after having been
sworn to in accordance with law, do hereby depose and state that:
1. My total aggregate landholdings, including that parcel of land containing a land
area of ONE HUNDRED (100) SQUARE METERS, located at Tuding, Itogon
Benguet, that I sold to ANDREW M. PALMA, thru a Deed of Absolute Sale of a
Registered Land covered by Doc. No. 12; Page No. 2; Book No. I; Series of 2012
of the Notarial Registry of Atty. ROSEMARIE D. PAGALA of Baguio City,
Philippines, dated April 21, 2012, does not exceed FIVE (5) hectares;
2. I am executing this affidavit in compliance with Department of Agrarian Reforms
Administrative Order no. 1-89, as well as to show proof that my total aggregate

land holdings, including the portion of land I sold to ANDREW M. PALMA does
not exceed five (5) hectares;
IN WITNESS WHEREOF, I have hereunto set my hands this 4TH day of February
2016, in the City of Baguio, Philippines.
________________________________
LUCIE ANTONNETTE D. LUCERO
Affiant
TIN: 888-327-911
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Lucie Antonnette D. Lucero, who has satisfactorily
proven her identity to me through her Community Tax Certificate No. 00252718 issued
on January 24, 2016 in Baguio City, and that she is the same person who personally
signed the foregoing affidavit before me and acknowledged that she executed the
same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 28;

Page No. 6;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.
x ------------------------------------------- x

AFFIDAVIT OF TRANSFEREE
I, MARIELLE M. MAGRATA, single, of legal age, Filipino citizen and
a resident of # 21 Green Valley Village, Baguio City, Philippines, after
having been sworn to in accordance with law, do hereby depose and state
that:
1. My total aggregate landholdings, including the parcel of land
containing a land area of ONE HUNDRED TWENTY (120) SQUARE
METERS, located at Buhaw, Puguis, La Trinidad, Benguet, that I
acquired from IDERLYN P. MAGSAMBOL, thru a Deed of Absolute
Sale of a Registered Land covered by Doc. No. 27; Page No. 6; Book
No. I; Series of 2012 of the Notarial Registry of Atty. BRYAN M.
CHOA of Baguio City, Philippines, dated May 25, 2012, does not
exceed FIVE (5) hectares;

2. That I am executing this affidavit in compliance with Department of

Agrarian Reforms Administrative Order No. 1-89, as well as to show
proof that my total aggregate land holdings, including the portion of
land I acquired from CHERRY G. DICANG does not exceed five (5)
hectares;
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of
February 2016, in the City of Baguio, Philippines.
__________________
MARIELLE M. MAGRATA
Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines,
this 4th day of February 2016, by Marielle M. Magrata, who has satisfactorily proven her
identity to me through her Community Tax Certificate No. 00252729 issued on January
16, 2016 in Baguio City, and that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.
NOELLE GRACE B. RILLON
Notary Public

Doc. No. 29;

Page No. 6;
Book No.
I;
Series
of
2016
REPUBLIC OF THE PHILIPPINES}

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF OWNERSHIP WITH UNDERTAKING

I, RICHELLE Q. OLIVIA of legal age, Filipino, single and a resident of No. 34 Ciudad Grande,
Bakakeng, Baguio City, Philippines after having been duly sworn to in accordance with law, do hereby
depose and say that:
1. I am the absolute and legal owner of a GSM handset described as follows:
Make/Model:
SAMSUNG GALAXY S III - Black
International Mobile Equipment Identification (IMEI): 4754711148287792
2. On October 25, 2012, I executed an Affidavit of Ownership and Loss with Undertaking and filed
the same with the National Telecommunication Commission to authorize said commission and all
CMTS to block the said GSM handset for the reason that said cellphone was stolen from me by
unidentified person/s during a trip to Boracay;
3. However, on November 25, 2013, I was able to retrieve said GSM handset through a common
friend;
4. I hereby request/authorize the National Telecommunication Commission and all CMTS carriers to
unblock the said GSM Handset;

5. I hereby undertake to hold free from any responsibility or shall not hold NTC and the abovementioned carriers liable for whatever claims, loss or damages or any party may institute by
reason of NTCs action to unblock the afore-mentioned unit;
6. In support of this request and as proof of my ownership of said cellphone unit, I attached hereto a
photocopy of the following documents:
A.
Social Security System Identification Card Number 8835789
B.
Professional Drivers License No. AD-8885523122
C.
Employment Identification Card No. SMC-02-1558
D.
Police Report No. M-23145 (October 27, 2012)
E.
Receipt No. SM-899975
7. I am executing this affidavit to attest to the truth of the foregoing facts and for whatever legal
intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016 in the City of
Baguio, Philippines.
__________________________
RICHELLE Q. OLIVIA
Affiant
Passport No. NN1245899

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 4th
day of February 2016, by Richelle Q. Olivia, who has satisfactorily proven her identity to me
through her Community Tax Certificate No. 00256598 issued on January 4, 2016 in Baguio City,
and that she is the same person who personally signed the foregoing affidavit before me and
acknowledged that she executed the same.

NOELLE GRACE B. RILLON

Notary Public

Doc. No. 30;

Page No. 6;
Book No.
I;
Series of 2016

Until December 31, 2017

City Budget Office, Baguio City Hall
Baguio City
Tel No.: (074) 442-8931
PTR No. 2198282, 04-30-18
IBP O.R. No. 1008288, 4-14-18
Roll No. 66288, 04-29-18
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No. II-0002267, 01-15-19
TIN 428-986-655