Pro-forma Waiver

REPUBLIC OF THE PHILIPPINES )

___________________________ ) S.S.

WAIVER OF RIGHTS

I, Daniel R. Villanueva, of legal age, married to Ester L. Villanueva, both Filipino,

with postal address at 2472-B Aladin St. Pandacan, Manila, after having been duly sworn to in
accordance with, hereby depose and say:

That I am the owner of right over a certain lot situated at Blk. 14, Lot 77, Pla-pla St.,
Phase III-E-I, DDDP., Longos, Malabon City, Metro Manila, containing an area of Fifty (50)
square meters;

That considering the fact that I am no longer interested to the said lot and has failed to
comply with the CA’s requirements and financial obligation, I desire to transfer the same to other
person;

That such as, I am waiving all my rights, interest and participation over the same in favor
of Reynaldo P. Tan, likewise of legal age, married to Remedios S. Tan, both Filipino and with
residence and postal address at 430 Inocencio St. Tondo, Manila;

That we cause to execute this affidavit to attest to the truth of the foregoing facts and for
whatever legal intents and purposes that this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of

_____________ at ____________________, Philippines.

____________________________ ____________________________ ____________________________

___ ___ ___
Daniel R. Villanueva Ester L. Villanueva Reynaldo P. Tan
Transferor Transferor/Wife Transferee

SIGNED IN THE PRESENCE OF:

_________________________ _________________________

SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and in

______________________ this ______ day of _______________ 20__, affiant exhibiting to me
his/her Community Tax Certificate No. _______________, issued on
_________________, at ___________________, Philippines.

NOTARY PUBLIC

Doc. No. _____

Book No. _____
Page No. _____
Series of 20___