FORM NO.20.

AFFIDAVIT OF PRELIMINARY
ATTACHMENT

Affidavit of Preliminary Attachment

REPUBLIC OF THE PHILIPPINES)

CITY OF BAGUIO ) S.S.

I, SALEEMA D. REFRAN, Filipino citizen, of legal age,

single, residing at #69 Upper Quirino Magsaysay, Baguio
City, Philippines, under oath, state:

1. That I am the plaintiff in a civil case entitled Saleema D.

Refran, vs. Jack D. Pot;

2. That a sufficient cause of action exists against the

defendant named
therein;

3. That this action is one of those specifically mentioned in

Sec. 1 of Rule 57 of the Rules of Court, whereby a writ
of preliminary attachment may lawfully issue, namely:

in an action against a party who has removed or

disposed of
his property, or is about to do so, with intent to
defraud his creditors;

4. That there is no other sufficient security for the claim

sought to be enforced by the present action; and

5. That the amount due to the plaintiff in the above-

entitled case is as
much as the sum for which an order of attachment is
proper.

Affiant further says none.

IN TRUTH WHEREOF, I have hereunto signed my name

below, this day of 26 January, 2017 in the City of Baguio,
Philippines.

Saleema D. Refran
Affiant

SUBCRIBED and sworn to before me, this day of 26

January 2017, in the City of Baguio, Philippines, by Saleema

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D. Refran exhibiting to me her Passport with no.
63724427462 issued on April 16, 2015 at Baguio City,
Philippines.
BAGUIO CITY,
PHILIPPINES

ATTY. DENVER A.
GAMLOSEN
NOTARY PUBLIC
#1 Feliz Loy Building, Shuntug
Street, Bokawkan road, Baguio
City Commission Serial No.
105
BAGUIO CITY, Until December 31, 2017
PHILIPPINES Roll No. 10987
P.T.R. No. 0007, 1/4/2017,
Doc. No. _20___;
Baguio.
Page No. _20__;
IBP No. 0003, 1/9/2017,
Book No. __4__;
Series of 2017. Baguio.
MCLE Compliance No. 1234

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