You are on page 1of 1

Republic of the Philippines)

__________________________) s.s.


I, JUAN DELA CRUZ, of legal age, married, Filipino citizen, and a

resident of _______________________________, Philippines, after having been
sworn to on oath in accordance to law, hereby depose and state that:

1. I am one of the surviving heirs of the late _____________________ who is

the declared owner of a parcel of land situated in
_______________________ under ________________________________;

2. The above-described land has an old house constructed thereat. Due

to the caducity of said building, it has become risky and hazardous to
passers-by, hence my sister applied for a demolition permit at the
Office of the Building Official;

3. In lieu thereof, I hereby signify my written consent freely, willingly

and voluntarily to demolish said old house on the above-mentioned
parcel of land for the safety of everyone;

4. I therefore execute this affidavit to attest to the truth of all the

foregoing facts as to my undertaking to give my consent for the
demolition of the old house and for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_______________________ in ______________________, Philippines.


ID No. ________________

SUBSCRIBED AND SWORN TO before me this ______________ in ____________________,

Philippines, by the affiants who are known to me on the basis of competent document shown
as proof of her identity.