MLP-01666 (05.2022) Republic of the Phi Province/City/Mut pines ) ipality of__)S.S. AFFIDAVIT OF HOUSING LOAN BORROWER (DUPLEX ACCOUNT) Housing Loan Penalty Condonation Program me, . Filipinos, of legal age, single/married to and residing at and Fespeatively (if more than one afiant with different address), affer having ‘Sworn according to law, hereby depose and state that: 1. (We am/are the housing loan borrower/s (mortgagor/s) under Mortgage Contract/Amended Mortgage Contract with as co-mortgagor; 2. IMe have an outstanding housing loan with the Social Security System (SSS) in the amount of Php per latest Statement of Account as of , breakdown shown below, and wish to avail of the Housing Loan Penalty Condonation Program: \Scheduled Principal Balance [A] Php (XX.XXX.XX] otal Amount Due [8] Php (XX XXX.XX]| Total Unpaid Amorization z Php DOK YKXX]| Principal : Php PROD] interest Php XOX] Penalty Php DX XXK XX] Fire ang Earthquake Insurance Premium Php DX YXKXX] Mortgage Redemption Insurance Premium [Php XX XK XX] Legal Exoenses. = Php POX XXX XX] ‘TOTAL OUTSTANDING OBLIGATION [AB] _ Php XX XXX XK] Note: Total amount of obligation (excluding legal expenses, any) fe subject fo confmalion wih Investments Accounting Department. 3. We anvare fully aware and understand the solidary liability as expressly agreed upon in the Mortgage Contract/Amended Mortgage Contract and undertake to pay in full the aggregate outstanding loan under the Mortgage Contract/Amended Mortgage Contract, and any action for reimbursement for the share of mylour co-morigagor are to be settled exclusively between us without any responsiblity on the part of SSS; 4. IANe shall hold the SSS free from any liabilty whatsoever and/or reimburse SSS for any damages that the latter may incur in the event that itis determined that !hve misrepresented any of the foregoing statements in connection with my/our application for the Housing Loan Penalty Condonation Program; and 5. IMe execute this affidavit for the purpose of attesting to the truth of the foregoing statements and as ‘compliance to one of the requirements for my/our application for the Housing Loan Penalty Condonation Program. IN WITNESS WHEREOF, Ie have hereunto set my/our hands. this day of 20__at AFFIANT AFFIANT (Signature Over Printed Name) (Signature Over Printed Name) SUBSCRIBED AND SWORN to before me this day of : : at. , affiantis having exhibited to me hishherfheir valid govemment issued IDs issued at on , 20___ as competent proof of iiistherfineir identity. NOTARY PUBLIC Doc. No. Page No, Book No. Series of