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Republic of the Philippines)

Done: ____________________) s.s.

I, MARIO A. AGCUS, of legal age, widower, Filipino citizen and a resident
of No. 35, Purok 28, Irisan, Baguio City, Philippines, after having been duly
sworn to in accordance with law hereby depose and states that:
1. I am an owner of Stall No. 1, BLOCK IV located at the City Market,
Baguio City;
2. My daughter Ursula T. Agcus, learned that a Deed of Transfer of
Rights Over Stall was allegedly signed by me and Lourdes V. Placido,
a resident of No. 58 Lower Phil-am Compound cor. Marcos Highway,
Baguio City, transferring the Stall in favor of Lourdes Placido;
3. The said Deed of Transfer of Rights Over Stall was notarized in
Muntinlupa City by Atty. Reynan G. Retazo, under Doc. No. 84; Page
No. 18; Book No. XXVIII; Series of 2014;
4. However, I did not sign any document regarding the transfer of my
stall to somebody. My signature in the Deed of Transfer is not my
signature and I have no Community Tax Certificate. Furthermore, my
name in the said document is Mario. A. Agcos, the correct spelling of
my name is MARIO A. AGCUS. It clearly shows that they forged my
5. What Lourdes Placido is asking is that she will be allowed to stay in
my Stall and I did not authorized or allow or give my consent to
transfer my rights in her favor;
6. If ever, I will waive my stall, it should only to my daughter, my sole
child, because she is the one who paid and settled all the problems
due to my stall;
7. By virtue of the aforementioned circumstances I hereby revoked,
annul the Deed of Transfer of Rights Over the Stall and should be
considered as null and void;
8. I am executing this affidavit to attest to the veracity and truthfulness
of the foregoing and for all legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this ______th day
of ______________________ 2014 at ________________________, Philippines.


SUBSCRIBED AND SWORN to before me this _____th day of

_______________________ 2014 at _______________________, Philippines. Affiant
personally appeared before me and to be the same person who executed this
instrument voluntarily.
Doc. No. ________;
Page No. ________;
Book No. _______;
Series of 2014.