Republic of the Philippines)

Province of Negros Oriental) S.S.

Municipality of Sibulan. . . .)

AFFIDAVIT OF OWNERSHIP AND UNDERTAKING

I, DOUGLAS C. NILLAS, of legal age, married, Filipino and a resident of

Poblacion, Sibulan, Negros Oriental, after having been duly sworn to in accordance with
law, state and declare that:

1. RITCHIE TAN is the owner of a NORECO II account with Account No.

0303100250 and Meter No. FE-8100 in Campaclan, Sibulan, Negros Oriental;

2. That I am the owner of the house and lot which the said NORECO II
account with Account No. 0303100250 and Meter No. FE-8100 is connected;

3. That I am applying for the transfer of the said NORECO II account with
Account No. 0303100250, Meter No. FE-8100, in Campaclan, Sibulan, Negros Oriental
membeship and ownerhsip in my name;

4. That I in effect exclude the authorities of the NORECO II for any liability
(administrative, civil or criminal) in connection with the said transfer of connection;

5. I am executing this affidavit to establish all of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

____________ in Sibulan, Negros Oriental, Philippines.

DOUGLAS C. NILLAS
Affiant

SUBSCRIBED AND SWORN to before me, a Notary Public, on this

____________, for the Municipality of Sibulan and the Province of Negros Oriental,
Philippines, the above-named affiant, who exhibited his OSCA ID No. 01924 issued on
Februay 10, 2009 and WHO SIGNED IN MY PRESENCE the foregoing document
(AFFIDAVIT OF OWNERSHIP AND UNDERTAKING), and who avows under
PENALTY OF LAW to the whole truth of the contents of the same.

Doc No. ____;

Page No. ____;
Book No. ____;
Series of 2022.