REPUBLIC OF THE PHILIPPINES)

CITY OF )S.S.
X----------------------------------------X

AFFIDAVIT OF ROAD RIGHT OF WAY

We, NAME , single; , NAME , widow; , NAME , single; and ,

NAME , married to , Name , all of legal ages, Filipinos and all are residents
of Brgy. , Mun. , Prov. , Philippines, after having been duly
sworn to in accordance with law, do hereby depose and say:
That we are the declared owners of a parcel of land situated in the Brgy.
, Mun. , Prov. , known as Lot , Psd- , with an area of
<WORDS> ( 00,000 ) square meter, more or less, covered by Transfer Certificate
of Title No. T- ;
That we caused the subdivision of the said parcel of land into ( ) sublots;
That we designated a road right of way of 3.00 meters wide, known as Lot ;
That we are executing this affidavit to prove the fact that we designated a road right
of way of 3.00 meters wide from the above-mentioned parcel of land.

IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
, 2014 in the City of , Philippines.

Name and Signature Identifying Documents

NAME ________________________________

NAME ________________________________

NAME ________________________________

NAME ________________________________

SUBSCRIBED AND SWORN to before me this _____day of __________________ , 2014

in the City of Iloilo, Philippines.

Doc. No. ________

Page No. _______
Book No. _______
Series of 2014.