Republic of the Philippines )

City of Davao
)s.s.
X - - - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, LUISITO G. BAGUIO, of legal age, Filipino, with residence address at Toril,
Davao City, after having been sworn in accordance with law, state under oath:
That I am a holder of a Professional Drivers license with license no. L02-92080803 by the Land Transportation Office (LTO), Davao City;
That I was also issued an Official Receipt (O.R.) by the LTO, however, said
O.R. went missing and despite efforts to locate, the same could no longer be
found and is now considered lost;
That I am executing this affidavit to attest to the truth of the foregoing facts
and for whatever legal purpose this may serve;
IN WITNESS HEREOF, I have hereunto set my hands this _____ day of March,
2014 in the City of Davao, Philippines.

LUISITO G. BAGUIO
Affiant
SUBCRIBED AND SWORN TO before me this _____ day of March, 2014 in the City of
Davao, Philippines.
Doc. No. ________
Page No. ________
Book No. ________
Series of 2014

WAIVER
In line with strict implementation of the rules under R.A. 82914 of GSIS, which pertains
to the payments/remittances on premium contributions within the first ten (10) days of
the calendar month of the following month which the contribution applies, I hereby abide
and agree to the conditions set forth by the policy.
Thereto, I am making myself responsible on the payment of 2% simple interest computed
from the due date to the date of receipt of payment for premium contributions both
personal and government share.
Further, this waiver acknowledges that I will personally pay the interest to the GSIS and
attach the Official Receipt of payment to the payroll for proper documentation and
processing.

CAMILLE C. GESTUVEO
Name and Signature of Employee

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES)
CITY OF DAVAO
)
X-----------------------X
BEFORE ME, a Notary public for and in the City of Davao, In this _____day of July,
2010, personally appeared.
Name

CTC No.

Date Issued

Place of Issue

1. CAMILLE C. GESTUVEO

Republic of the Philippines )

City of Davao
)
X - - - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, I, MARILEN ASUEROS, of legal age, Filipino, and a resident of 87-126
Jacinto Arellano Extension, Davao City, after having been sworn in accordance with law,
hereby depose and say:
1.)

That I am the lawful mother of John Arthur M. Asueros;

2.)

That my son is a bonafide graduate of Davao City National High School;

3.)

That my son was issued a High School Report Card;

4.) That said high school card was misplaced and despite efforts to locate it, the
same can no longer be retrieved and is now considered lost;
5.) That I am executing this affidavit to attest to the truth of the foregoing facts
and for whatever legal purpose this may serve;
IN WITNESS WHEREOF, I have hereunto set my hands this ______ day of May,
2012 in the City of Davao, Philippines.

MARILEN ASUEROS
Affiant
SUBCRIBED AND SWORN TO before me this _____ day of May 2012, in the City of
Davao, Philippines. Affiant exhibiting to me her Community Tax Certificate No.
__________ issued on __________________ at Davao City.

Doc. No. ________

Page No. ________
Book No. ________
Series of 2012

CONTRACT OF LEASE
This Lease Contract is made and entered into by and between:
The LESSOR, FEDERICO C. MINA, of legal age, Filipino, married and a
resident of Purok 20, Fausta St., Calinan, Davao City, Philippines;
AND
The LESSEE, MARY JANE MISSION, single, of legal age, and a resident of
Purok 20, Fausta St. National Highway, Calinan, Davao City, Philippines.

WITNESSETH, THAT
The LESSOR hereby allows the LESSEE to lease a commercial space located at Davao
Bukidnon Road, Fausta, Calinan, Davao City under the following terms and conditions:
1. The terms of this contract shall be for a period of four (4) years to commence
on February 28, 2014, renewable thereafter.
2. The LESSEE shall pay a monthly rental of Two Thousand Five Hundred
Pesos (2,500.00 ) Philippines Currency for the leased premises for the period
February 9, 2010 to February 28, 2014.
3. The LESSEE shall not sublease the lease premises without the written consent
of the LESSOR;
4. The LESSEE shall not make any alterations, or improvements whatsoever
without the prior written consent of the LESSOR, provided however, that all
such alterations, additions or improvements made by the LESSEE upon the
leased premises except the movable fixtures & furniture & other
improvements which could be removed without damages or injury to the
leased premises shall become the property of the LESSOR without any
obligation on the part of the LESSOR to pay for its cost;
5. The LESSEE shall pay for all water, light, telephone and other public utility
services used or consumed at the leased premises during the leased contract;
6. Failure to pay monthly rental for two (2) successive months means the
LESSEE should vacate the leased premises without need of demand from the
LESSOR reserves the right to close and lock the premises if the LESSEE fails
to vacate the place;
7. Upon termination of the period of this contract, the LESSEE shall surrender &
vacate peaceably the leased premises and the LESSOR reserves the right to
close & lock the leased premises if the LESSEE fails to vacate the same upon
termination of the contract;

IN WITNESS WHEREOF, the parties hereunto affixed their signatures this 9th
day of February, 2010 in Davao Bukidnon Road, Fausta, Calinan, Davao City,
Philippines.

FEDERICO C. MINA
Lessor

MARY JANE MISSION

Lessee

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES

CITY OF DAVAO
) S.S
Before me, A Notary Public, personally appeared Luzviminda L. de los
Reyes with CTC No. 20659350 issued on March 23,2009 in Sto. Tomas,
Davao del Norte and Mary Jane Mission with CTC No 20981621 issued on
February 02, 2010. Known to me to be the same persons who executed the
foregoing instrument, consisting of two pages including the page where my
signature appears and signed by the parties and their witnesses in the proper
places on pages and acknowledged to me that the same is their free act & deed.
WITNESS MY HAND AND SEAL, on the date & place first above
written.

Doc. No. _________

Page No. _________
Book No._________
Series of 2010

REPUBLIC OF THE PHILIPPINES)

CITY OF DAVAO
)
X-----------------------X

AFFIDAVIT OF NO LANDHOLDING
I, JAMES A. SOLIVA, of legal age, Filipino, single and a resident of 22 Palma
Gil St., Bo. Obrero, Davao City after having been sworn in accordance with law, do
hereby depose and say:
1.

That I am an applicant for a residential lot at the Housing & Homesite

Division of the City Planning and Development Office, City of Davao;

2.

That I hereby declare that I have no landholding in Davao City or elsewhere

under our name;

3. That I am executing this affidavit to attest to the truth of the foregoing facts
and for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this __________
day of August, 2009 at Davao City, Philippines.

JAMES A. SOLIVA

Affiant
SUBSCRIBED AN SWORN to before me this ___________ day of August, 2009
at Davao City, Philippines. Affiant exhibited to me his CTC No. _________ issued on __
_____________ at _______________________.

Doc. No.______
Page No. ______
Book No. ______
Series of 2009

Republic of the Philippines )

City of Davao
)s.s.
X - - - - - - - - - - - - - - - - - -X

AFFIDAVIT OF NON-RENTAL

I, BERNADETTE G. AL-AG, of legal age, Filipino, married and a resident of Purok 5,

Barangay Bankas Heights, Toril, Davao City, Philippines, after having been sworn to in
accordance with law, hereby depose and state that:
1. That I hereby declare upon my honor that ROCHELLE JOYCE G. AL-AG
is a tenant in the building I own located at Mc Arthur Highway, Saypon, Toril
District, Davao City;
2. The she is not paying any rent for the use thereof;
3. That I am executing this affidavit to attest to the truth and veracity of the
foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this ____________ day of

__________, Davao City, Philippines.

BERNADETTE G. AL-AG
Affiant

SUBSCRIBED AN SWORN to before me this ___________ day of February, 2012 at

Davao City, Philippines.

Doc. No.______
Page No. ______
Book No. ______
Series of 2012