REPUBLIC OF THE PHILIPPINES)

CONSOLACION, CEBU ) S.S.

AFFIDAVIT
(For Certification of Total Landholding/s)

That I, ________________________________________, of legal age, Filipino,

single / married / widow / widower, a bonafide resident of
________________________________________, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

1. That I am the legitimate owner and possessor or authorized

representative of the owner: ______________________________ (thru an
SPA/authorization), who possesses a parcel/s of land, situated at
Consolacion, Cebu, as listed hereunder:

Tax Declaration Lot No. Location Area Declarant/s

2. That I hereby attest that this/these is/are the only property/ies

registered/owned/declared under the name/s of
________________________.

3. That I am hereby requesting the Office of the Provincial/Municipal

Assessor to issue a Certification of Total Landholding/s of said declarant
for the purpose of _________________________.

4. That this Affidavit is executed to attest to the correctness of the above-

mentioned and to request for the issuance said Certification.

5. Affiant further sayeth none.

________________________________________
Affiant
Valid ID: ____________________________
Valid until: _____________

SUBSCRIBED AND SWORN to before me, a Notary Public, this

_______________ at Consolacion, Cebu, Philippines. Affiant exhibited to me
his/her competent evidence of identification indicated below his/her signature.

Doc. No. _____

Page No. _____
Book No. _____
Series of 2021