CONSENT AND AUTHORITY

I, __________________________________________________________ of legal age, married,

Filipino citizen/s a resident of with postal address at ___________________________________
after having been duly sworn to according to law and say;

1. That I am a lawful _________________________________________________________

(Owner / Claimant / Administrator)
to Lot. No. ________________________described in ____________________________
(OCT or TCT No.)
along _____________________________situated in the Bario of ___________________
( if adjoining Ave / Blvd, St.)

_____________________________ City of ________________.

2. That with my full knowledge and consent, I hereby authorized Mr./Mrs.

___________________________ to ___________________________________ his / her
(Construct / Remodel / Renovate / Repair)
___________________________________ over the above mentioned property.
(Structure)

3. That I will assume liability and responsibility in case of landownership controversy over
the said parcel and parcels of land that may arise as a result of this CONSENT AND
AUTHORITY.

4. IN WITNESS WHEREOF, I hereby affixed my signature this _______________ day of

________________________ at Pinamungajan, Cebu, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this _______________ day of

___________________, at Pinamungajan Cebu, Philippines. Affiant exhibited to me his/her
Res. Cert. No. ___________________ issued on ______________________ at Pinamungajan,
Cebu, Philippines.

Doc. No.________
Page No. _______
Book No. _______
Series No. ______
20_______