Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
2. That I have always kept the same inside the topmost part of my bedside table
drawer;
3. However, when I looked for it on October 25, 2015 as I intend to spend the
upcoming Christmas holiday in Brussels, I could not find it ;
4. That diligent efforts were exerted to recover the said passport but the same
proved futile and fruitless;
5. That the said passport was lost in the manner stated above and was not
confiscated nor cancelled by the issuing agency or other agencies for violation
of any of its terms and conditions, laws, rules and regulations;
6. That I am now executing this affidavit to attest to the veracity of the foregoing
narration for securing a replacement of the said lost passport and for all legal
intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February
2016, in the City of Baguio, Philippines.
_______________________
FRANCO N. CAWILI
Affiant
3. However, when I looked for it on January 25, 2016 as I intend to apply for
work elsewhere, I could not find it ;
4. That diligent efforts were exerted to recover the said ID but the same
proved futile and fruitless;
5. That the said ID was lost in the manner stated above and was not
confiscated nor cancelled by the issuing agency or other agencies for
violation of any of its terms and conditions, laws, rules and regulations;
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February
2016, in the City of Baguio, Philippines.
_______________________
MARIA M. CRESENCIA
Affiant
1. That I was issued by the Bank of the Philippine Islands (BPI) an automated
teller machine (ATM) card sometime on 2012;
4. That diligent efforts were exerted to recover the said ATM but the same
proved futile and fruitless;
5. That the said ATM was lost in the manner stated above and was not
confiscated nor cancelled by the issuing agency or other agencies for
violation of any of its terms and conditions, laws, rules and regulations;
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February
2016, in the City of Baguio, Philippines.
_______________________
MARIE M. BAUTISTA
Affiant
AFFIDAVIT OF EXPLANATION
I, MARCO N. ANTON, of legal age, Filipino citizen, single and with residence
and postal address at #1 Upper QM, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
2. That I have always kept the same inside the topmost part of my bedside
table drawer;
3. However, when I looked for it on October 25, 2015 as I intend to spend the
upcoming Christmas holiday in Brussels, I could not find it ;
4. That diligent efforts were exerted to recover the said passport but the same
was found destroyed in the cage of our dog;
5. That the said passport was lost in the manner stated above and was
mutilated by our dog;
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
MARCO N. ANTON
Affiant
AFFIDAVIT OF ACCIDENT
I, RODRIGO V. DUMDUM, of legal age, Filipino citizen, single and with
residence and postal address at #12 Upper Rock Quarry, Baguio City, having been duly
sworn in accordance with law, do hereby depose and state:
3. That on January 5, 2016, at about 2:30 A.M., I was carefully traversing the
Marcos Highway, heading to Baguio City while driving a cargo truck loaded
with several crates of fresh mangoes for delivery ;
4. That apparently however, one of the vehicles on the other side of the
highway has overtaken the trailer ahead of it;
5. That considering the condition of the road, the overtaking vehicle smashed
off a piled-up soil on the rightmost side of the road where I was traversing,
thereby causing it to crash and spread out several rock particles on the
middle of the highway;
6. That the overtaking vehicle has successfully passed the scenario without
any untoward incident on its part, whereas, in my case, it brought my truck
to an abnormal state;
7. That the truck I was driving has lost its break and it even took me
approximately one (1) kilometer distance before I managed to maneuver
the truck to stop;
10. That through a trail of information, Mr. Alex Batulan, Claims Officer of
Aboitiz 2GO, came over along on the area with some of the rescue team at
about 6:00 PM of the following day;
12. That this affidavit is executed to attest to the truth of the above-narrated
facts and to further testify to the veracity of the foregoing statement.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
RODRIGO V. DUMDUM
Affiant
1. That the lien claimant furnished certain material and performed certain
labor or work in furtherance of improvements located on the land
hereinafter described, pursuant to a certain contract, with the owner, Ms.
Grace L. Salinas;
2. That the first of the labor was performed and material was furnished on the
fifth day of January 2016;
3. That the last of the labor or work was performed on the second day of
February ;
4. That there is justly and truly due the lien claimant therefore from the owner,
as the case may be, over and above all legal setoffs, the sum of one
hundred thousand pesos (P100,000.00);
5. That for which amount, the lien claimant, claims a lien on the land of the
owner, which premises are described as follows: #89 Bakakeng Central,
Baguio City;
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
MARIO A. DIAZ
Affiant
I, SASHA H. GREY, of legal age, Filipino citizen, single and with residence and
postal address at #18 Lower Rock Quarry, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
2. I recently changed the color of the said motor vehicle from color blue to pink.
3. I therefore have executed this Affidavit to cause the necessary changes in the
registration of the above- mentioned vehicle in the Land Transportation Office, to
attest the truth I mentioned herein and for whatever legal purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
SASHA H. GREY
Affiant
I, CHRISTIAN H. GREY, of legal age, Filipino citizen, single and with residence
and postal address at #96 Andres Bonifacio, Baguio City, having been duly sworn in
accordance with law, do hereby depose and state:
1. That I am the owner of a certain registered motor vehicle, which I inherited from
my deceased father through intestate succession, with the particular description
as follows, to wit:
MAKE: Honda
BODY: Sedan
SERIES: Civic
MODEL: 2000
PLATE NO.: UAS 231
Serial/Chassis No.: US24- 1B5789
MV FILE No.: 2477- 33438
3. That I therefore have executed this Affidavit to cause the necessary changes in
the registration of the above- mentioned vehicle in the Land Transportation
Office, to attest the truth I mentioned herein and for whatever legal purposes it
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
CHRISTIAN H. GREY
Affiant
1. That said Corporation is the owner of certain parcel of land, more particularly
described as follows:
TCT No. T-2222
2. That the said aforementioned Transfer Certificate of Title over said property
includes and contains all the permanent improvements and buildings located and
situated thereon;
3. That I execute this Affidavit to attest and declare the truth of the foregoing facts
and for whatever legal purposes that this Affidavit may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
ELIZABETH O. CLEMENTE
Affiant
AFFIDAVIT OF SERVICE
4. That Rica Kaye O. Lomibao refused to receive the demand letter and
told me instead that she will just talk and settle her obligation to my
husband personally;
5. That I am executing this affidavit in all good faith and to attest the
truth of the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
ELLEN A. ADARNA
Affiant
AFFIDAVIT OF PUBLICATION
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
DIANA P. ZUBIRI
Affiant
We, Benjamin A. Bualat Jr. of legal age, Filipino, Ivy Joy G. Ombayan, of legal age,
Filipino, both are residents of #14 Emerald St. Ecoland Subdivision, after having been sworn to in
accordance with law hereby depose and say that:
2. On November 28, 2010, we started to live and treat each other as husband and wife living
in one roof up to the present without the benefit of marriage;
3. During our cohabitation, we do not engage in other relationship with the opposite sex;
4. Our cohabitation is continuous and uninterrupted from November 2010 up to the present
which is more than five (5) years;
5. We have two children namely: Louie Jay O. Bualat and Daryn Nicole O. Bualat. Louie Jay
is three (3) years old and Daryn Nicole is one (1)year old;
6. We planned to get married on January 2017 for our interest and for our children as well so
that they will be legitimated;
7. We are executing this affidavit to attest the truth of the foregoing and to inform the
authorities concerned to exempt us from obtaining a marriage license.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________ _______________________
BENJAMIN A. BUALAT JR. IVY JOY G. OMBAYAN
Affiant Affiant
AFFIDAVIT OF CO-OWNERSHIP
1. That there is an ancestral property under Survey No. 4567, Sub Div No. 5478
in Imelda Village barangay measuring 100 Ha in the name of John O. Manuel
as owner;
2. That John O. Manuel has expired on 28 December 2015 and has left behind
Legarda O. Manuel, his son, as the heir and that the inheritance and mutation
proceedings are in progress with the authorities;
5. That the facts contained hereinabove in paragraphs 1 to 4 are true to the best
of my knowledge.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
_______________________
LEGARDA O. MANUEL
Affiant
1. That we are the parents of MENCHIE N. DOROTAN, who is 10 years old and a citizen of the
Republic of the Philippines and a holder of valid Philippine Passport with No. NN3311221
and who is going for a trip abroad specifically to Washington DC, USA this February 15,
2016;
2. That we are giving our full consent to our said daughter to travel abroad or specifically to
Washington DC, USA;
3. That for this purpose, we have sufficient and adequate financial capacity to support and
defray the said travel and do hereby undertake to finance her trip abroad from the
application fees, airline tickets, board and lodging, pocket money and such other
expenses that she may incur so that she would neither be a burden to the state nor at their
place of destination at any time during his trip abroad;
4. That there is no criminal case pending in court against her nor has she been charged of
subversion, rebellion, insurrection or any crime or offense involving moral turpitude in any
court of the Philippines;
5. That further, MENCHIE N. DOROTAN will be accompanied or escorted by her doctor, Atty.
LEISLY KEITH CASTILLO in her travel abroad;
6. That we are hereby giving our full consent to said ATTY. LESLY KEITH CASTILLO to
accompany or escort MENCHIE N. DOROTAN in her travel abroad; and
7. That we are executing this affidavit to declare the truth of the foregoing facts and for
whatever legal purpose it may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this 4 TH day of February 2016 in
the City of Baguio, Philippines.
__________________________ ___________________________
EDWARD JACOB C. NAVARRO ISABELLA MARIE S. NAVARRO
Affiant Affiant
AFFIDAVIT OF DESISTANCE
I, CHRISTIME H. EBREO, single, of legal age, Filipino citizen, with residence and postal address
at #35 Cabinet Hill, Baguio City, after having been duly sworn in accordance with law, do hereby depose
and state:
1. That I am the Private Complainant in Criminal Case No. 35667-R for violation of B.P. Blg. 22
otherwise known as the Bouncing Checks Law now pending before the Regional Trial Court,
Baguio City, Branch 3;
2. That the accused DIANA C. DY has settled his obligations with me to my full satisfaction;
3. That due to the aforementioned reason, I freely and voluntarily pray for the FINAL DISMISSAL of
the case against Diana C. Dy;
4. That I am no longer interested to pursue the case against said Diana C. Dy;
5. That I am now requesting the Office of the City Prosecutor of Baguio City and the Honorable
Court, Regional Trial Court, Branch 3 of Baguio City to have the case withdrawn against Diana
C. Dy;
6. That I am executing this Affidavit of Desistance to attest to the truth of all the foregoing facts, as
well as, to withdraw my complaint against Diana C. Dy, and ultimately have the case against him
be dismissed.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in
the City of Baguio, Philippines.
_______________________
CHRISTIME H. EBREO
Affiant / Private Complainant
Passport No. GG8553422
CERTIFICATION
This is to certify that I have personally examined the affiant and I am convinced that he
voluntarily executed his statement and understood the contents thereto.
_____________
William Vargas
Public Prosecutor
AFFIDAVIT OF DISCREPANCY
1. I was born to spouses Ricardo A. Angues and Dulnuan D. Barcanao on 16 March 1978
at Baguio General Hospital, Baguio City, Philippines;
2. Since childhood I have been using Victoria Barcanao Angguis as my complete name in
all my transactions;
3. Recently, however, when I secured a copy of certificate of live birth from the National
Statistics Office I was surprised to discover that my complete name entered therein is
Baby Girl Barcanao Angues instead of Victoria Barcanao Angguis;
4. The erroneous entry of my given name Baby Girl and the erroneous use of my family
name Angguis instead of Angues were due to inadvertence and was never meant to
hide my true identity or to evade any obligations;
5. The names Victoria Barcanao Angguis and Baby Girl Barcanao Angues refers to one
and the same person;
6. Finally, I am executing this affidavit to attest to the veracity and truthfulness of the
foregoing declarations and for all intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February
2016, in the City of Baguio, Philippines.
________________________
VICTORIA ANGUES-LANGAOAN
Affiant
1. That we personally know CHRISTIE JOY G. BACAL of #7 Badihoy St., Guisad, Baguio
City, being acquaintance for a long period of time;
2. That she is a PAG-IBIG Fund member with an application for Provident Benefits with the
Fund;
3. That the said application is required to be accompanied by a copy of the applicant’s birth
certificate, however, no record can be obtained, as shown by the attached Certification
of Non-Availability of Birth Record from the National Statistics Office (NSO);
4. That we certify that she was born at Baguio General Hospital, Baguio City Philippines,
on the 14th day of February in the year 1977 ;
5. That she has been using the said birth date in all her documents and transactions,
including her education and employment records;
6. That we are not related by affinity or consanguinity to the above mentioned person; and
7. That we are executing this affidavit to attest to the truth of the foregoing facts for record
and references purposes.
IN WITNESS WHEREOF, we have hereunto set our hands this 4th day of February 2016, at
Baguio City, Philippines.
___________________ ____________________
ALFREDO L. BALLEBER ARIA NADINE CONCEPCION V. BALIGO
Affiant Affiant
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 4th
day of February 2016, by Alfredo L. Balleber and Aria Nadine Concepcion V. Baligo, who has
satisfactorily proven their identities to me through their Community Tax Certificate No.
00265252 and 00265262, respectively both issued on January 13, 2016 in Baguio City, and that
they are the same person who personally signed the foregoing affidavit before me and
acknowledged that they executed the same.
SUPPLEMENTAL AFFIDAVIT
I, JANET LEO-THOMAS, of legal age, Filipino citizen, and residing at Kanluran, Barlig, Mt.
Province, under oath, state that:
2. My parents are MIKE C. LEO and IRENE Q. DAGOL who were married on September 24, 1954
at Sablan, Benguet;
3. Recently, I secured a copy of my Certificate of Live Birth from the Office of the Civil Registrar
of Baguio City and I discovered that my name was registered as “BABY GIRL D. LEO”; and the same is
true when I secured a copy of my Certificate of Live Birth from the National Statistics Office (NSO);
4. As long as I can recall, I have been using the name JANET D. LEO ever since I entered school,
and all records pertaining to me bear my name as JANET D. LEO, and now that I am married, I carry the
name JANET LEO-THOMSON;
5. I do not know of any other person named “BABY GIRL D. LEO” born on September 09, 1960,
whose parents are MIKE C. LEO and IRENE Q. DAGOL except myself, and I am certain that the names
“BABY GIRL D. LEO” and JANET D. LEO refer to one and the same person who is no other than myself;
6. I am executing this Supplemental Affidavit to attest to the truth of the foregoing and for all
legal intents it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February 2016, in the City of
Baguio, Philippines.
___________________________
JANET LEO-THOMSON
(JANET D. LEO a.k.a. BABY GIRL D. LEO)
AFFIDAVIT OF PATERNITY
2. That the fact of the said birth was duly recorded with the Local Civil Registrar of
Kabayan, Benguet with Registry No. 2010-089;
4. That I hereby attest to the truthfulness of the foregoing statements and for
whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hands this 4th day of February
2016 at Baguio City, Philippines.
AFFIDAVIT OF LEGITIMATION
We, the spouses STANLEY GOTOHIO and JHAYNE B. USON-GOTOHIO, both of legal
age, Filipinos, with residence and postal address at #47 Quisumbing St., Trancoville, Baguio
City, Philippines, having been duly sworn in accordance with law, do hereby depose and state
that:
2. Out of our relationship was born a son on March 3, 2011 whom we named
NATHANAEL AEOMER;
3. As our son was born out of wedlock, he is considered illegitimate and he bears the
family name of his mother which is USON;
4. We subsequently got married on August 22, 2012 at St. Joseph Parish Church in
Pacdal, Baguio City as evidenced by our Certificate of Marriage;
5. At the time of the birth of our child, NATHANAEL AEOMER, we possessed all the
qualifications and none of the disqualifications to marry each other;
6. As a result of our marriage, the status of our child is legitimized and as such, he shall
now bear the family name of his father which is GOTOHIO;
7. We execute this affidavit to attest to the truth of the foregoing statements and for the
purpose of causing the legitimation of the status of our child, NATHANAEL AEOMER
and for all legal intents and purposes this may well serve;
IN WITNESS WHEREOF, we hereunto set our hands this 4TH day of February 2016 in the
City of Baguio, Philippines.
________________________ __________________________
STANLEY GOTOHIO JHAYNE B. USON-GOTOHIO
Affiant Affiant
AFFIDAVIT OF ILLEGITIMACY
1. I am the biological mother of Cherry Kaye T. Habacon, who was born on March 23
2002, at St. Paul Hospital, and who is a resident of Enrile, Cagayan. Attached hereto
and made as integral part hereof is an NSO copy of the birth certificate of my child.
2. That as appearing in the records of Office of the Civil Registrar of the Municipality of
Enrile, Province of Cagayan, Philippines, the father of the said child is Edwin G.
Pamittan, who is a Filipino citizen. The same is certified by the attached Certificate of
Live Birth of the said child.
3. That I hereby affirm and attest to the truth of the fact that the father of the above-
mentioned child is indeed Edwin G. Pamittan.
4. That at the time my child was born, I was not legally married to her biological father, nor
am I legally married to the said father now. Attached is a copy of a Certificate of No
Marriage and made an integral part hereof.
5. This Affidavit is being executed in order to attest to the truth of the foregoing facts and
for whatever purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in the
City of Baguio, Philippines.
______________________________
PHOEBE CORAZON T. HABACON
Affiant
AFFIDAVIT OF GUARDIANSHIP
1. That I am the mother of the minor named below who have an interest in the
PAG-IBIG provident benefits of my late husband SHERWIN A. FERONEL
payable by the PAG-IBIG Fund;
4. That I am competent to receive in behalf of the said minor any amounts due her;
and
IN WITNESS WHEREOF, I have hereunto set my hand this 27TH day of June 2014,
at Baguio City, Philippines.
_______________________
LEONARDITA A. FERONEL
Affiant
AFFIDAVIT OF SUPPORT
1. I am the brother of MIA LORIE T. FUENTEBELLA, with pending application for Student Visa with the
Department of Immigration and Citizenship of Canada;
2. I am willing to extend my whole hearted support for her studies in Canada, I being her brother and
have the financial capability to provide all her needs during the period of her studies;
3. At present, I am maintaining a bank account with BDO Banking Corporation located in Session Road
Branch in Baguio City, Philippines under passbook savings account number 18-14-57937-4 and Time
Deposit Account Number COD 789981 with an amount of Two Million Five Hundred Twenty One
Thousand Seven Hundred Fifty Pesos and Twenty-eight centavos (Php2,521,750.28) where I
can source out all needed expenses that my sister may use during her studies should her application
be granted;
4. In relation to the support, I have authorized MIA LORIE T. FUENTEBELLA to withdraw any amount
from my bank account which she needs during the period of her studies. Attached to this affidavit is a
copy of the said authorization marked as annex “A” to form an integral part hereof;
5. Aside from my savings mentioned in paragraph 3 of this affidavit, my other source of income where I
can source out additional financial support to MIA LORIE T. FUENTEBELLA are from my salaries and
earnings in the United States;
6. I shall provide any other support that she may need other than money should it be necessary or as
maybe further required by the Canadian Government during the period of her studies in said country;
7. I am executing this affidavit to attest the truth of the foregoing facts and to support the application of
MIA LORIE T. FUENTEBELLA, my sister, for the issuance of her student visa and for all legal intents
this affidavit may lawfully serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in Baguio City,
Philippines.
___________________________
DOMINIC T. FUENTEBELLA
Affiant
AFFIDAVIT OF SELF-ADJUDICATION
I, Maychelle S. Ablog, of legal age, Filipino, single and a resident of No. 115 Maria Basa, Pacdal, Baguio
City, Philippines, after having been duly sworn in accordance with law, do hereby depose and say:
1. That I am the only son of Peter B. Ablog who died intestate in the City of Baguio, on September 3, 2011 as
evidenced by Death Certificate issued by the Civil Registrar of Baguio, hereto attached as ANNEX “A” and
made an integral part of this Affidavit;
2. That said deceased left an estate consisting of a parcel of land measuring ONE THOUSAND (1,000)
SQUARE METERS, located at Mary Hills Road, Loakan Proper, Baguio City covered by Transfer Certificate
Title No. CC-19876 of the Registry of Deeds of Baguio City;
3. That the said parcel of land is more particularly described as follows to wit;
4. That the said deceased left no debts nor any LAST WILL AND TESTAMENT;
5. That pursuant to Rule 74, Section 1 of the Rules of Court, I hereby adjudicate unto myself the above
described Real Estate by means of this Affidavit and hereby files the same with the Register of Deeds of
Baguio City with the request that said adjudication be made effective without the judicial proceeding as
prescribed by the aforementioned Rules of Court.
IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of February 2016 at Baguio City,
Philippines.
____________________
MAYCHELLE S. ABLOG
Affiant
TIN: 842-596-319
AFFIDAVIT OF EMPLOYMENT
____________________
CLARITA G. BATULAN
Affiant
LIEDA B. ABELLERA
Affiant
I, JENNY LISA M. BALAWAN, single, of legal age, Filipino citizen, and a resident of
88F Lower Brookside, Baguio City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:
1. That I am the President and Chief Executive Officer of Field Crest Real Estate Planning
and Development, Inc., a corporation duly organized and existing under the laws of the
Philippines, with principal office at Unit 4F,4th Floor Yorkshire Building, Legarda Rd.,
Baguio City, Philippines;
2. That said corporation was incorporated on June 14, 2009 and acquired by the
undersigned with the purchase of its corporate property in the above address sometime
in July 2010 but has not yet commenced its operations in view of the slump in the real
estate industry in the country;
3. That the stockholders and directors of the corporation are contemplating on reviving its
operations in the near future when the opportune time comes;
4. That this affidavit is being executed in order to attest to the truth of the foregoing
circumstances and for the purpose of complying with the reportorial requirements of the
Securities and Exchange Commission.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016, in the
City of Baguio, Philippines.
______________________
JENNY LISA M. BALAWAN
Affiant
TIN: 443-511-214
AFFIDAVIT OF TRANSFEROR
IN WITNESS WHEREOF, I have hereunto set my hands this 4TH day of February
2016, in the City of Baguio, Philippines.
________________________________
LUCIE ANTONNETTE D. LUCERO
Affiant
TIN: 888-327-911
AFFIDAVIT OF TRANSFEREE
__________________
MARIELLE M. MAGRATA
Affiant
2. On October 25, 2012, I executed an Affidavit of Ownership and Loss with Undertaking and filed
the same with the National Telecommunication Commission to authorize said commission and all
CMTS to block the said GSM handset for the reason that said cellphone was stolen from me by
unidentified person/s during a trip to Boracay;
3. However, on November 25, 2013, I was able to retrieve said GSM handset through a common
friend;
4. I hereby request/authorize the National Telecommunication Commission and all CMTS carriers to
unblock the said GSM Handset;
5. I hereby undertake to hold free from any responsibility or shall not hold NTC and the above-
mentioned carriers liable for whatever claims, loss or damages or any party may institute by
reason of NTC’s action to unblock the afore-mentioned unit;
6. In support of this request and as proof of my ownership of said cellphone unit, I attached hereto a
photocopy of the following documents:
A. Social Security System Identification Card Number 8835789
B. Professional Driver’s License No. AD-8885523122
C. Employment Identification Card No. SMC-02-1558
D. Police Report No. M-23145 (October 27, 2012)
E. Receipt No. SM-899975
7. I am executing this affidavit to attest to the truth of the foregoing facts and for whatever legal
intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4TH day of February 2016 in the City of
Baguio, Philippines.
__________________________
RICHELLE Q. OLIVIA
Affiant
Passport No. NN1245899
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 4th
day of February 2016, by Richelle Q. Olivia, who has satisfactorily proven her identity to me
through her Community Tax Certificate No. 00256598 issued on January 4, 2016 in Baguio City,
and that she is the same person who personally signed the foregoing affidavit before me and
acknowledged that she executed the same.