REPUBLIC OF THE PHILIPPINES)

__________________________ )S.c.
X--------------------------------------------X
SWORN STATEMENT
I, __________________________ , of legal age, Filipino, married and a resident of FilInvest East, Marcos Highway, Cainta Rizal, and Parang, Maguindanao, after having been duly
sworn to law, depose and state:
1. That I am the same and identical person named above who is the
__________________________ ;

wife of

2. That we are wife and husband, respectively having been legally married in accordance
_________________________________________________ , per hereto attached Certificate of
__________________________ , duly registered at __________________________ Civil
__________________________ , Copy hereto attached as Annex-A and formed part of this
Sworn Statement;
3. That out of our lawful wedlock we were blessed with two (2) children, namely:
a. __________________________ , 19 years old
b. __________________________ , 14 years old
4. That during our marriage coveture we were able to acquire the following real
properties, to wit;
a.
Lot
No.4,
__________________________
,
situated
at
__________________________ , containing an area of 125 SQM, registered in the name of the
Parties, marked as ANNEX-D;
5. That when we parted ways with my ex-husband I asked for support for our children
and my former husband told me to take care /enrich/preserve the aforementioned Parcels of
Land with the right to transfer, convey sell or use as collaterals in case of loans for the support
and maintenance of our children taking into consideration their general welfare and interest;
6. That I am Executing this affidavit to attest to the truth of the foregoing statements.
IN
WITNESS
HEREOF,
__________________________ .

have

hereunto

set

my

hand

__________________________
Affiant
SUBSCRIBED AND SWORN to before me this __________________________

this