REPUBLIC OF THE PHILIPPINES)

PROVINCE OF PANGASINAN 0) S.S.

MUNICIPALITY OF MANGALDAN)

AFFIDAVIT OF AUTHORIZED REPRESENTATIVES

I, (name of authorized representatives) of legal age Filipino citizen, single/married with

postal address at _______________________________after being duly sworn in accordance with
law, hereby depose and state that:
1. I am the authorized representative of _____________ (hereafter referred to as “Principal”),
a buyer of a house and lot/lots only/condominium unit in ______________ by virtue of the
appointment embodied in the letter attached hereto as Annex “A”.
2. I acknowledge that a special attorney to be used by the principal in my favor is necessary
to give my appointment any legal effect;
3. I undertake to submit the said special power of attorney to ALC within (30) days from
execution of this Affidavit, in order to avoid cancellation of the principal’s account
pursuant to Section 3 of the Reservation Agreement;
4. In the event of cancellation of the account under the preceding paragraph, I shall hold the
ALC free and harmless from any liability arising from the cancellation of the Principal’s
account;
5. I am executing this affidavit for the purposes of obtaining provisional authority to transact
with ALC for and in behalf of the principal until such time as special power of attorney is
based in my name.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___day of January,

2018 in Mangaldan, Pangasinan.

___________________________
Affiant
ID No._____________________
SUBSCRIBED AND SWORN to before me this ___day of January, 2018 in Mangaldan,
Pangasinan.

Doc. No. _____;

Page No. ____;
Book No. ____;
Series of 2018.