REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
That I am the registered owner of a parcel of land situated in (Address of Property) containing an area of
ONE HUNDERED (100) SQUARE METERS, covered by Transfer Certificate of Title No. 000-00000-0 issued by the Registry of Deeds for Makati City.
That on the above said title there was an erroneous entry on the Technical Description particularly on the boundaries of the above-said parcel of land.
That on the boundaries of the above-said parcel of land on the original title theerrors made consists of:
a) Missing Boundary: Bounded on the SE., along line 1-2 by Road lot 10, (8.00m. Wide)
b) Bounded on the
“SE”
, along line 2-3 by lot 9, block 11 both of the consolidation-subdivision plan INSTEAD OF
“SW”
, along line 2-3by lot 9, block 11 both of the consolidation-subdivision plan
That the technical description as appearing on the original title are as follows:
“A parcel of land (lot 8, block-11, of the consolidation-subdivision plan Pcs-07-003066 being a portion of cons-subs. Of lot 12864, SW0-07-05-001934 and lot 3,Psu-151805.) situated in the Barangay of _________, Municipality of __________,Province of _______, Island of _________. Bounded on the SE., along line 2-3 by lot9, block-11, both of the consolidation-subdivision plan; on the NW., along line 3-4 by lot 9441, Cad. 545-D, (NEW); on the NE., along line 4-1 by lot 7, block-11,of the consolidation-subdivision plan.
That the correct information or technical description of the said land as certified by Engr. Mark Santos, Regional Director for Technical Services are as follows:
“A parcel of land (lot 8, block-11, of the consolidation-subdivision plan Pcs-07-003066 being a portion of cons-subs. Of lot 12864, SW0-07-05-001934 and lot 3,Psu-151805.) situated in the Barangay of ____________, Municipality of ____________, Province of _______, Island of ___________. Bounded on the SE., alongline 1-2 by Road lot 10, (8.00m. wide; on the SW., along line 2-3 by lot 9, block-11, both of the consolidation-subdivision plan; on the NW., along line 3-4 by lot9441, Cad. 545-D, (NEW); on the NE., along line 4-1 by lot 7, block-11, of theconsolidation-subdivision plan.
That I am executing this affidavit to attest to the truth of the foregoing facts and incompliance of the requirements of the Registry of Deeds for Makati City for the annotation of the correct information in the title and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification (ID Number) issued on (Date) in (Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
That I am the widow of (Name of Husband) who died on (Date of Death) in Meycauayan City because of severe injuries sustained in a vehicular accident as per autopsy result conducted by Dr. ---------;
2. That per investigation of the Meycauayan City Police Station, my husband was driving along the southlane of Meycauayan Interchange in front of Sterling Industrial Park in Meycauayan City when he was hit/bumped by a truck coming from the opposite direction; copy of the Traffic Investigation Report is hereto attached as Annex "A";
3. That at the time of the incident, my husband was a duly licensed driver carrying Driver's License No. 00000 and was riding on a Toyota Innova, gray in color and with Plate No. AAA-000 owned by me with Certificate of Registration No. 000000000;
4. That I am executing this affidavit in support of my application for insurance claim with _____________, to attest to the truth of the foregoing, and for whatever legal purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification (ID Number) issued on (Date) in (Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
I, the undersigned Director and President of a corporation under the corporate name of (Name of Corporation) , a corporation duly organized and existing by virtue of the laws of the Republic of the Philippines, with principal office at (Principal Office Address of the Corporation), Philippines, DO HEREBY CERTIFY:
1. That since the year 2020, the aforesaid corporation has ceased its operation and did not conduct any transaction of its business until the present date.
2. As such, I am executing this affidavit to attest to the truth of the foregoing, and for purposes of appropriate action by the Securities and Exchange Commission and other agencies.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)
Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification(ID Number) issued on (Date) in(Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
1. That I am a holder of Automated Teller Machine (ATM) Card No. 0000000000 duly issued in my favor by Bank of Philippine Islands, on (Date) in Quezon City;
2. That I used to put said ATM card in my wallet;
3. That sometime on January 5, 2022, when I arrived home from work, I discovered that said ATM card was no longer in my wallet;
4. That diligent effort to locate the same proved futile;
5. That in view thereof, I now desire and hereby request BDO to issue another ATM card in lieu of the lost one;
6. That I bind myself to save BDO harmless from any loss or damage that it may incur in connection with the issuance of a new ATM card in lieu of the lost one;
7. That I am executing this affidavit to attest to the foregoing facts and for any legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification (ID Number) issued on (Date) in (Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
That I am the true owner of _______________, described as follows to wit: (Description of property)
That the said automobile had been duly registered in my name in the Land Transportation Office in ___________ for the year (or years) ____________;
That the certificate of registration and other pertinent papers of ownership of said automobile were among those flooded and destroyed on ____________ when my house and all my personal belongings were completely destroyed by storm and flood;
That said papers are now beyond recovery.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification(ID Number) issued on (Date) in(Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.