Republic of the Philippines )

Province of Ilocos Norte ) S.S.

)
x----------------------------------------------x

AFFIDAVIT
I, Mrs. LORIELINDA P. OASAY, of legal age, Filipino citizen with postal
address and residence at Brgy. Pagdilao, Pinili, Ilocos Norte after having sworn
to in accordance with the law, hereby depose and state:

1. That I am the Agent/Attorney-in-Fact of RUVY A. PAGDILAO by virtue of

an Special Power of Attorney issued on August 8, 2019 which was
Acknowledge before the Philippine Consular Office at Saipan, USA am
the owner of a certain parcel of land located at
Brgy._________________________, more particularly described as follows;

“A parcel of land under Tax Declaration No. 2009-11-0025-00528,

under Cad. Lot. 6284, located in Lioac Norte, Naguilian, La Union
more specifically described and bounded on the North by 12,14,15;
on the East by 18; on the South by 17, sec .011, and on the West by
sec.005, with an area of six thousand five hundred sixty three (6,563)
square meters, more or less.”

2. That the abovementioned property is subject of application for

locational clearance/certificate of zoning compliance for building of a
residential house;
3. That the abovementioned property was acquired by way of a deed of
sale______________;
4. That to the best of my knowledge, the abovementioned property is
situated within alienable and disposable lands and outside lands
reserved for the public domain;
5. That to the best of my knowledge, the abovementioned property is
free from any alienation or encumbrances;
6. That I am executing this affidavit to attest to the veracity of the
abovementioned facts thereby satisfying the requirements relative to
the application for Locational Clearance/Certificate of Zoning
Compliance for the above mentioned project;
 7. That I am giving consent to Mr._________________________ to construct
his residential building within my lot.

IN WITNESS HEREOF, I have hereunto affixed my signature, this______of

____________ at the Consular Office of_______________________.

______________________________
Affiant

SUBSCRIBED AND SWORN to before me this_____of June 2019 in

_____________________________. Affiant exhibiting to me his ________________issued
at___________________________on ________________________.

NOTARY PUBLIC
CONSULAR OFFICE

Doc No.______
Page No._____
Book No.______
Series of 2019.