Sworn Statement

I affirm that each of the statement made in this application is true and correct and
agree to notify LBP of any material change affecting the information contained herein. I
authorize LBP to obtain and verify such information as may be required covering this application
from the above references or any other sources. I agree that all information obtained by LBP
shall remain its property whether or not the loan is granted.

I hereby swear that I/we have no outstanding loan/s from LBP, or outstanding loans
from any other creditor for the same project.

I hereby agree that, should there be any misrepresentation discovered, LBP may cause
the outright disapproval of the loan application and, if the loan has been granted, LBP may
immediately declare the loan due and demandable.

In WITNESS WHEREOF, I have hereto signed on this _________________ day of

______________________________________ at _________________________________

________________________________________
Signature Over Printed Name of Applicant

SUBSCRIBED AND SWORN to before me, this ______________ day of ___________________,

affiant exhibited to me his/her _______________________________________________ (valid
identification number) issued on __________________________.

Notary Public
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.