You are on page 1of 1

REPUBLIC of the PHILIPPINES )

CITY of BAGUIO ) S.S.

AFFIDAVIT

I, JOSEPHINE DE PERALTA PINEDA, of legal age, married,


Filipino citizen, and with postal address at Bakakeng Norte Road, Baguio
City, Philippines, after having been sworn to in accordance with law, do
hereby depose and state that:

1) Sometime in the year 2013, I loaned the total amount of one


million pesos (PhP1,000,000.00) from one Regilyn P. Luga;

2) As previously agreed, I now intend to settle the full amount of


my obligation, and the same shall be deposited through telegraphic
transfer to her US Account;

3) I am effecting this Affidavit in compliance with the


requirements of the proper authorities to facilitate the above-described
transaction;

4) I am executing this Affidavit to attest to the truth of the


foregoing, to satisfy the requirements of the proper government
agency, and for all legal intents and purposes that it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day


of April 2016, at Baguio City, Philippines.

JOSEPHINE DE PERALTA PINEDA


Affiant
DLR No. A01-01-080041
Expires on 03-19-2019

SUBSCRIBED and SWORN to before me, a Notary Public, this 8 th


day of April 2016, in the City of Baguio, Philippines. Affiant exhibited to
me her government-issued identification card, bearing her photograph and
signature, the details of which appearing below her name. The affiant
avowed to the truthfulness of the foregoing statements.

Doc. No. ;
Page No. ;
Book No. ;
Series of 2016.

You might also like