REPUBLIC OF THE PHILIPPINES )

CITY OF MAKATI ) S.S.

AFFIDAVIT OF OWNERSHIP

I, _______________, single/married, of legal age, Filipino, with address at

____________________________________, after having been duly sworn in
accordance with law, hereby depose and state that:

1. I am currently residing in _________________________ at the above

given address;

2. I am the true and absolute owner of a painting by

_____________________, a photograph of which is attached herewith as
Annex A;

3. Said painting was given to me by my mother, ______________, who

currently resides at ________________________________________;

4. My mother, in turn, inherited the painting from her father,

_________________, after the latters death in ______;

5. My grandfather acquired the said painting sometime in the 1980s and has
been in possession of it until his death in ____________;

6. I desire to bring and transport said painting to my residence at

_________________________ USA;

7. I am executing this affidavit to attest to the truth of the foregoing facts and
to for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

________________ at Makati City, Philippines.

_____________________
Affiant

SUBSCRIBED AND SWORN to before this ______________ at Makati City.

Affiant exhibited to me his _______________ issued on _____________ in
___________________.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of ____.