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I, __________, of legal age, married, Filipino citizen, and residing at
__________________, after having been sworn in accordance with law
hereby depose and state:
1 That I am the representative and attorney-in-fact of
__________________, as per Special Power of Attorney
attached herewith;
2 That _______ and her husband ________ are the owners of a
house and lot located at _________________;
3 That the construction of the residential building at
_________________ was completed on January 12, 2015. It is
now ready for occupancy;
4 That the Architect/ Civil Engineer who prepared and signed the
building plan and Application for Building Permit as Full-time
inspector and supervisor of the construction works was
5 That we can no longer locate ___________ and we have no knowledge
about his present whereabouts;
6 That we have
exerted diligent efforts to locate and find
_____________ but our efforts proved to be futile;
7 That I am executing this affidavit to attest to the truthfulness of
the foregoing facts and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day
of October, 2015 in Caloocan City, Philippines.
SUBSCRIBED AND SWORN to before me, this 20th day of October,
2015 in Caloocan City, Philippines, affiants exhibiting to me his competent
evidence of identity by way of BIR TIN Card No. ______________.

Doc. No. :_______

Page No.:_______
Book No. :_______
Series of 2015