Republic of the Philippines)

Province of Negros Occidental)

City of Bacolod) S.S.

AFFIDAVIT
I, CORA LOU GAITAN FLORES, of legal age, married to BONNIE P.
FLORES, Filipino citizen, and a resident of Brgy. Tangub, Bacolod City, Negros
Occidental, Philippines, having been duly sworn in accordance with law,
hereby depose and state:

1. That I and my husband are the registered owners of a parcel of land

located at Mt. Carmel Subdivision, Brgy. Alijis, Bacolod City, Negros
Occidental, covered by Transfer Certificate of Title No. ___________,
a copy of which is herein attached as “ANNEX A”;

2. That I am currently updating my Tax Declaration with the City of

Bacolod;

3. That sometime on

4. As such, I execute this Affidavit to attest to the truth of the foregoing

facts and for any other legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this _____

day of May, 2019, at Bacolod City, Negros Occidental, Philippines.

CITROBELLE A. ALDEGUER
Affiant

SUBSCRIBED AND SWORN TO before me this _____ day of May,

2019 in the City of Bacolod, Negros Occidental, Philippines, affiant personally
appeared and exhibited to me her _______________ as her competent proof
of identification.

Doc. No. _____

Page No. _____
Book No. _____
Series of 2019.