E. 10 Samples of Affidavit

SUBMITTED BY: KRISHA FAYE F.
AMBOL
(1 AFFIDAVIT OF COHABITATION)
REPUBLIC OF THE PHILIPPINES)

CITY OF DAVAO ) S.S.
x-------------------------------------x
JOINT AFFIDAVIT OF COHABITATION
WE, UUU R. MMM and HHH N. PPP both of legal age, Filipino, single (living together)
and residents of Purok 2-4 Davao City, after having been duly sworn to in accordance with law,
depose and state THAT:
1. We have been living together as husband and wife under the same roof, continuously and
without any interruption, since 2000 or a period of more than five (5) years;
2. During our cohabitation and even until the present, we remain both of single status and, hence,
there exists no legal impediment for us to marry each other;
3. We were blessed with one son named JJJ K. RRR who was born on October 13, 2004 in
Davao Doctors Hospital Davao City;
4. We are executing this affidavit to attest to the foregoing facts and for the purposes of
contracting marriage without the need of securing the marriage license pursuant to the provisions
of Article 34 of the Family Code of the Philippines.
IN WITNESS WHEREOF, we have hereunto set our hand this 26th day of April 2021 in
Davao City, Philippines.
UUU R. MMMM HHH N. PPP

AFFIANT AFFIANT
PRC ID NO.: 232-456 UMID:903-567-333

Competent proof of Identity Competent proof of Identity
SUBSCRIBED AND SWORN TO before me this 26th day of April 2021 in Davao City,
Philippines, affiant exhibiting to me Their competent proof of identities issued in Davao City.
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(2 AFFIDAVIT OF LOSS)

x-------------------------------------x
AFFIDAVIT OF LOSS
I, AAA B. CCC, of legal age, Filipino, single and a resident of 2223 Washington Street, Pio del
Pilar, Davao City, after having been duly sworn to in accordance with law, depose and state:
1. That I am a holder of Automated Teller Machine (ATM) Card No. 123456789 duly issued in
my favor by Banco de Oro Unibank, Inc. on January 12, 2010 in Davao City;
2. That I used to put said ATM card in my wallet;
3. That sometime on July 20, 2013, when I arrived home from work, I discovered that said ATM
card was no longer in my wallet;
4. That diligent effort to locate the same proved futile;
5. That in view thereof, I now desire and hereby request BDO to issue another ATM card in lieu
of the lost one;
6. That I bind myself to save BDO harmless from any loss or damage that it may incur in
connection with the issuance of a new ATM card in lieu of the lost one;
7. That I am executing this affidavit to attest to the foregoing facts and for any legal purpose it
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 26th day of April 2021 in Davao
City, Philippines.
AAA B. CCC
Affiant
Competent proof of identity: Philippine Passport No. 123456
Philippines, affiant exhibiting to me her Philippine Passport No. 123456 issued in Manila on
January 12, 2020 and valid until January 12, 2025.
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(3 AFFIDAVIT OF ADVERSE CLAIM)

x-------------------------------------x
AFFIDAVIT OF ADVERSE CLAIM

I, AAA B. CCC, of legal age, Filipino, single and a resident of 2223 Washington Street, Pio del
Pilar, Davao City, after having been duly sworn to in accordance with law, depose and state:
1. That on July 10, 2020, I have entered into a Deed of Conditional Sale which was
acknowledged on the same date before Notary Public Juan Tamad of Davao City and entered in
his Notarial Register as Doc. No. 2, Page 2, Book II, Series of 2013. A copy of the said Deed is
hereto attached as ANNEX “A” and made an integral part of this Affidavit;
2. That in the said Deed of Conditional Sale, I was the VENDEE of a certain parcel of land
covered by Transfer Certificate of Title No. 111222, more particularly described as follows:
A parcel of land (Lot 457-A-12-B-2-B-2-A) of the subdivision plan (LRC) Psd-2114428, being a
partion of Lot 457-A-12-B-2-B-2 (LRC) Psd-1774344 L.R.C. Record No. 3563, situated in Barrio of
Bagbag, Quezon City, Island of Luzon. Bounded on the N. points 2 to 3 by existing road 8 m. wide; on
the E. and S. points 3 to 4 and 4 to 1 by Lot 457-A-12-B-2-B-1 (LRC) Psd-177344. Beginning at a
point marked "l" on plan beginning 50 deg. 50'E., 457.01 m. from L.W. 22, Piedad Estate; thence N.
22 deg. 40'3., 28.02 m. to point 2; thence N. 85 deg. 54'3., 15.00 m. to point 3; thence S. 1 deg. 57'W.,
25.06 m. to point 4; thence S. 85 deg. 54'W., 24.97 m. to the point of beginning; containing an area of
FIVE HUNDRED (500) SQUARE METERS more or less
3. That because I still have a balance on the purchase price in the amount of P500,000.00 which
is payable within one (1) (year) from the date of signing thereof, it was stipulated in the
aforementioned Deed that title and ownership over the subject property will only be transferred
upon full payment of the same;
4. That the VENDOR in the said Deed of Conditional Sale agreed that upon its execution, said
Deed shall be annotated in the Title with the Office of the Register of Deeds of Davao City;
5. However, since the said Deed of Conditional Sale per se could not be annotated on the Title
with the Office of the Register of Deeds, I am therefore executing this Affidavit for the purpose
of attesting to the truthfulness of the foregoing allegations and in support of my request for
the annotation of an adverse claim over the parcel of land covered by the Transfer Certificate of
Title No. 111222.
City, Philippines.
AAA. B. CCC
Affiant
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(4 AFFIDAVIT OF ALTERATION)

x-------------------------------------x
AFFIDAVIT OF ALTERATION
I, AAA B. CCC, of legal age, Filipino, single and a resident of 2223 Washington Street,
Pio del Pilar, Davao City, after having been duly sworn to in accordance with law, depose
and state:
1. As Assistant Treasurer of the Salinas Electrical Company Inc., I issued in such capacity
the Charge Invoice No. 7095 dated 06 July 2009 to the Manila Electric Company;
2. However, the first digit in the serial number of the said Charge Invoice, which was
number seven (7), appeared to be unclear and thus unreadable;
3. To remedy the problem, i caused the superimposition of such first digit with no other
purpose than to make it clear to the person/s concerned or in whose favour the same was issued;
4. The same was done in good faith and for no other reason than to directly address the
problem and pursuant to the purpose stated in the immediately preceding paragraph.
5. I therefore have executed this Affidavit to attest to the truth I mentioned herein and for
whatever legal purposes it may serve.
City, Philippines.
AAA. B. CCC
Affiant
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(5 AFFIDAVIT FOR RA 3019)

x-------------------------------------x
AFFIDAVIT FOR ANTI-GRAFT AND CORRUPT

PRACTICES (RA 3019)
I, AAA B. CCC, of legal age, Filipino, single and a resident of 2223 Washington Street,
Pio del Pilar, Davao City, after having been duly sworn to in accordance with law, depose
and state:
1. That I am currently employed as Auditor in the Commission on Audit.
2. That I am retiring/ under RA 1616 to take effect on April 23, 2021.
3. That there is no administrative or criminal investigation against me for any offense, defined or

penalized under RA 3019, otherwise known as the Anti-Graft and Corrupt Practices Act, as
amended, and under the provisions of the Revised Penal Code on Bribery; and
4. That I am executing this affidavit to attest to the truth of the foregoing facts or assertation
in compliance with COA Memorandum No. 451 dated March 6, 1973.
City, Philippines.
AAA. B. CCC
Affiant
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2021.
(6 AFFIDAVIT FOR RA 3019-survivorship)

x-------------------------------------x
AFFIDAVIT FOR ANTI-GRAFT AND CORRUPT

PRACTICES (RA 3019 (Survivorship)
I, TTT Y. OOOO, of legal age, Filipino, widow and presently residing at DAVAO CITY having
been duly sworn to in accordance with law, depose and say:
1. That I am the widow of AAA N. MMM who was an employee of the Commission on Audit
(COA) until his/her death on March 3, 2021.
2. That I have applied for GSIS survivorship benefits as a surviving spouse effective April 20,
2021.
3. That to the best of my knowledge, my husband/wife has no administrative/criminal

investigation/charges against him/her for any offense, defined or penalized under RA 2019,
otherwise known as the Anti-Graft and Corrupt Practices Act, as amended, and under the
provisions of the Revised Penal Code on Bribery; and
4. That I am executing this affidavit to attest to the truth of the foregoing facts or assertation
in compliance with COA Memorandum No. 451 dated March 6, 1973.
City, Philippines.
TTT Y. OOOO
Affiant
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2021.
(7 AFFIDAVIT OF AUTHORIZATION)

x-------------------------------------x
AFFIDAVIT OF AUTHORIZATION
I, TTT Y. OOOO, of legal age, Filipino, widow and presently residing at DAVAO CITY
having been duly sworn to in accordance with law, depose and say:
1. I am the owner of a certain parcel of land in the subdivision in Tagaytay City- known as
Block 1, Lot 3- which is being developed by Doroteaville Developer Corporation.
2. Through this Affidavit, I hereby authorize Mr. FFF G. TTT not only to use and possess
the said property but also to continue paying it in the event there are still balances to be paid to
the developer, and have it consequently registered in his name.
3. I therefore have executed this Affidavit to attest to the truth I mentioned herein and for
City, Philippines.
TTT Y. OOOO
Affiant
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(8 AFFIDAVIT OF CANCELLATION OF ENCUMBRANCE)

x-------------------------------------x
AFFIDAVIT OF CANCELLATION OF
ENCUMBRANCE
I, TTT Y. OOOO, of legal age, Filipino, widow and presently residing at DAVAO CITY having
been duly sworn to in accordance with law, depose and say:
1. I am the registered owner of a parcel of land situated in Tagaytay City, with Transfer Certificate
of Title No. T- 73879 of the Registry of Deeds for Tagaytay City.
2. It was annotated in the previous certificate of title, which was copied from the certificate of title
in my name, “Pursuant to Sec. 8 of Republic Act No. 26, this certificate of title is without
prejudice to any party whose right or interest in the property was duly noted on the original of
the reconstituted certificate of title RT- 5 (130-a-1337) at the time it was lost or destroyed.”
3. From the time of the encumbrance was duly annotated, more than two (2) years have
already lapsed since the title was transferred in my name.
4. Thus, as can be deduced from the foregoing, the cancellation of the said encumbrance is
warranted and is in order.
5. I therefore have executed this Affidavit to attest the truth I mentioned herein and for
City, Philippines.
TTT Y. OOOO
Affiant
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(9 AFFIDAVIT OF CANCELLATION)

x-------------------------------------x
AFFIDAVIT OF CANCELLATION
1. I am presently engaged in a business under the name and style of Prime Choose
Consultancy Services.
2. The business is now aiming for expansion and is now attracting other investors in the
process.
3. To protect all the investors who are putting not an inconsiderable amount of capital, the
plan is to change the present business organization from sole proprietorship to incorporation.
4. Thus in so doing, the cancellation of the business registration in the Department of Trade
and Industry is now properly called for.
5. In changing the present organizational set- up, no creditors will be prejudiced because the
business has no obligation arising from contract, other monetary claims and sources of
obligation.
6. I therefore have executed this Affidavit to attest the truth I mentioned herein and for
City, Philippines.
TTT Y. OOOO
Affiant
Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.
(10 AFFIDAVIT OF CHANGE OF COLOR OF VEHICLE)

x-------------------------------------x
AFFIDAVIT OF CHANGE COLOR
1. I am the registered owner of a motor vehicle which is particularly described as follows:

MAKE: HONDA
ENGINE NO.: KPY00E130155
CHASIS NO.: KPY00130105
COLOR: BLACK
PLATE NO.: LD17345
O.R. NO.: 830529700
C.R. NO.: 230979501
2. The original color of the said motor vehicle was "BLACK";
3. When the paint of the above-described motor vehicle had faded, I had its color repainted to
"PINK" such that the color of the said motor vehicle was changed from "BLACK" to "PINK";
4. Said change of color is not intended for any illegal or unlawful purpose but solely due to the
foregoing reasons;
5. I am executing this Affidavit to attest to the truth of the foregoing and in support of the
application for the change of color of the above-described motor vehicle on its Certificate of
Registration.
City, Philippines.
TTT Y. OOOO
Affiant
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2021.

E. 10 Samples of Affidavit

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E. 10 Samples of Affidavit

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SUBMITTED BY: KRISHA FAYE F.

REPUBLIC OF THE PHILIPPINES)

JOINT AFFIDAVIT OF COHABITATION

UUU R. MMMM HHH N. PPP

PRC ID NO.: 232-456 UMID:903-567-333

Doc. No. _____;

REPUBLIC OF THE PHILIPPINES)

2. That I used to put said ATM card in my wallet;

4. That diligent effort to locate the same proved futile;

Doc. No. _____;

(3 AFFIDAVIT OF ADVERSE CLAIM)

REPUBLIC OF THE PHILIPPINES)

AFFIDAVIT OF ADVERSE CLAIM

Doc. No. _____;

REPUBLIC OF THE PHILIPPINES)

Doc. No. _____;

(5 AFFIDAVIT FOR RA 3019)

REPUBLIC OF THE PHILIPPINES)

AFFIDAVIT FOR ANTI-GRAFT AND CORRUPT

1. That I am currently employed as Auditor in the Commission on Audit.

2. That I am retiring/ under RA 1616 to take effect on April 23, 2021.

3. That there is no administrative or criminal investigation against me for any offense, defined or

(6 AFFIDAVIT FOR RA 3019-survivorship)

REPUBLIC OF THE PHILIPPINES)

AFFIDAVIT FOR ANTI-GRAFT AND CORRUPT

3. That to the best of my knowledge, my husband/wife has no administrative/criminal

REPUBLIC OF THE PHILIPPINES)

Doc. No. _____;

REPUBLIC OF THE PHILIPPINES)

Doc. No. _____;

REPUBLIC OF THE PHILIPPINES)

Doc. No. _____;

REPUBLIC OF THE PHILIPPINES)

AFFIDAVIT OF CHANGE COLOR

1. I am the registered owner of a motor vehicle which is particularly described as follows:

2. The original color of the said motor vehicle was "BLACK";

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