REPUBLIC OF THE PHILIPPINES

PROVINCE OF PANGASINAN
MUNICIPALITY OF MANGATAREM

AFFIDAVIT OF CONFIRMATION OF
SUBDIVISION
We, JUANITO B. LABASAN, JERRY B. LABASAN, ELISA B. LABASAN, ANNABELE L. BARROZO, MARINA B.
LABASAN, PERLITA B. LABASAN, EMMA L. ARMOGENIA, VICENTE B. LABASAN, Jr. and REGINA B.
ESPIRITU of legal ages, Filipinos and residents of Brgy. MARAVILLA-ARELLANO EXT., MANGATAREM,
PANGASINAN after having been duly sworn in accordance with law do hereby depose and say;

1. That we are the co-owners of that certain parcel of land situated by MARAVILLA-ARELLANO
EXT., MANGATAREM, PANGASINAN, designated as Lot no. ______, Cad. 786-D; containing an
area of __________ sq. m. Declared under Tax Declaration No. __________.
2. That we decided to terminate our co-ownership of the above-mentioned property and that
we engaged the services of a Geodetic Engineer to subdivide said parcel of land into 9 lots to be
approved by the DENR Land Management Services, San Fernando City, La Union;
3. That we are hereby agreed and confirmed said parcel of land shall be adjudicated in the
following manner to wit;

Lot _______ -J with an are of ____ sq. m. shall belong to JUANITO B. LABASAN;
Lot _______ -K with an are of ____ sq. m. shall belong to JERRY B. LABASAN;
Lot _______ -L with an are of ____ sq. m. shall belong to ELISA B. LABASAN;
Lot _______ -M with an are of ____ sq. m. shall belong to ANNABELE L. BARROZO;
Lot _______ -N with an are of ____ sq. m. shall belong to MARINA B. LABASAN;
Lot _______ -O with an are of ____ sq. m. shall belong to PERLITA B. LABASAN;
Lot _______ -P with an are of ____ sq. m. shall belong to EMMA L. ARMOGENIA;
Lot _______ -Q with an are of ____ sq. m. shall belong to VICENTE B. LABASAN, Jr.;
Lot _______ -R with an are of ____ sq. m. shall belong to REGINA B ESPIRITU;

4. That we hereby confirmed said subdivision plan including their corresponding technical
descriptions;

IN WITNESS WHEREOF, we have hereunto affixed our signatures, this _____________________ at

______________________________, Philippines.

JUANITO B. LABASAN JERRY B. LABASAN ELISA B. LABASAN

ID NO. ___________ ID NO. ___________ ID NO. ___________

ANNABELE L. BARROZO MARINA B. LABASAN PERLITA B. LABASAN

ID NO. ___________ ID NO. ___________ ID NO. ___________

EMMA L. ARMOGENIA VICENTE B. LABASAN, Jr. REGINA B. ESPIRITU

ID NO. ___________ ID NO. ___________ ID NO. ___________
 SUBSCRIBED AND SWORN to before me this ___________ at _______________________,
Philippines. Affiants executed to me their Community Tax Certificate Nos. indicated their names and
signatures.

Doc. No. __________

Page No. __________
Book No. __________
Series of 2022