Republic of the Philippines )

Province of Leyte ) S.S

x-----------------------------------------x

AFFIDAVIT OF UNDERTAKING

I, EVERGISTO BONGALAN of legal age, Filipino, single/married/widow, and a resident

of BRGY. HITUDPAN, HILONGOS, LEYTE after being sworn to in accordance law, do hereby
depose and say:

1. That I am one of the nearest kin of MARGARITA CRUZ SANTOS who is one of the
listed farmer beneficiaries of a parcel of land designated as Lot No. 9083 located at
Brgy Hitudpan, Hilongos, Leyte covered by CLOA No. OC 10475 with an area of
15, 681 square meters;

2. That the subject landholding is under the coverage of the SPLIT (Support to
Parcelization of Lands for Individual Titling) Project of the Department of Agrarian
Reform;

3. That I hereby state under oath that MARGARITA CRUZ SANTOS has passed away in
the year 2019;

4. That due to financial constraints, I am unable to acquire his/her death certificate, hence
I have no copy of such document;

5. That I, being his/her nearest kin hereby consent to the parcelization and the issuance of
Individual CLOA under his/her name.

6. That in order to expedite the parcelization process of the subject landholding, I shall
affix my signature on the necessary parcelization forms;

7. That I hereby affirm under oath that no co -owner shall be prejudiced by my acts;

8. That as such, I execute this Affidavit to certify or attest to the truth of the foregoing
narration of facts and for whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _________________ at

Tacloban City.

EVERGISTO BONGALAN

Affiant

SUBSCRIBED AND SWORN to before me this __________ in ____________,

Philippines. Affiant exhibited her competent proof of identity and affixed his signature before
me.