REPUBLIC OF THE PHILIPPINES)

PROVINCE OF BOHOL )
X-------------------------------------X

AFFIDAVIT OF NON-OWNERSHIP

I, JOVENCIA B. BONCALES, surviving spouse of late Lorenzo A. Boncales, Filipino, of legal age and
a resident of Poblacion, San Miguel, Bohol, Philippines, after having duly sworn to in accordance to
law do hereby depose and state:

1. That, I and my late husband Lorenzo Auxilio Boncales are not the owner of a certain parcels
of land described under Tax Declaration No. 2016-38-0004-00129 declared in the name
of Lorenzo Boncales located at Cabangahan, San Miguel, Bohol containing an area of
TWENTY-EIGHT THOUSAND SIX HUNDRED FIVE (28,605) SQUARE METERS and Tax
Declaration No. 2016-45-0031-00325 declared in the name of Lorenzo Boncales located
at San Pascual, Ubay, Bohol containing an area of NINE THOUSAND FIVE HUNDRED
TWENTY-FOUR (9,524) SQUARE METERS;

2. That, when I obtained a certification of landholdings at Provincial Assessor’s Office at

Tagbilaran City, there appears the aforementioned two parcels of land as part of our
landholdings which we do not owned;

3. That, I hereby declare that the aforementioned parcels of land located in Cabangahan, San
Miguel, Bohol and San Pascual, Ubay, Bohol, Phlippines and I hereby DISOWN ANY
PARTICIPATION, INTEREST AND OWNERSHIP over the aforesaid parcels of land;

4. That upon verification, the above-named parcels of land property belong to persons who
happen to have the same name of my late husband LORENZO AUXILIO BONCALES and the
only difference is that the owner of the said parcels of land has no middle initial which is
LORENZO BONCALES only;

5. That, I am executing this affidavit to attest to the truth of the foregoing facts and to prove
that we have no claim of ownership or any interest over the aforementioned parcels of land
embraced under Tax Declaration No. 2016-38-0004-00129 situated at Cabangahan, san
Miguel, Bohol and Tax Declaration No. 2016-45-0031-00325 situated at San Pascual, Ubay,
Bohol and for whatever legal purposes this may serve best.

IN WITNESS WHEREOF, I hereby affix my signature this __________________ at Poblacion, San

Miguel, Bohol, Philippines.

JOVENCIA B. BONCALES
AFFIANT
GSIS ID NO. CRN-000-6057-1676-6

SUBSCRIBED AND SWORN TO before me this _______________ at San Miguel, Bohol, Philippines
by affiants who exhibited to me her respective Valid ID as evidence of identity.

Doc. No._________;
Page No._________;
Book No. _________;
Series of 2021.