INDEMNITY AGREEMENT

I, _________, of legal age, Filipino, with postal and residence address at

____________, under and by virtue of these presents and in my personal capacity, do
hereby guarantee and undertake to reimburse any third person/s who may be
prejudiced and damaged by virtue of my withdrawal on the deposit account of the late
____________under account number Land Bank Savings Account (SA) NO.
____________.

I further agree to indemnify Land Bank of the Philippines for whatever damage
or prejudice it may suffer arising from any and all claims to be made by any third person
in connection with the above-stated account and in my withdrawal therefrom in an
amount, which is twice the amount of the decedent’s deposit. This Deed and my
undertaking contained herein shall be enforceable against me and my successors-in-
interest for four years from the date of withdrawal.

The undersigned also guarantees that our co-heirs who executed the waiver of the
right to claim the deposit under the above-described account in my favor pursuant to
the Deed of Extrajudicial Settlement of Estate of the late ____________ dated
__________ are the latters’ legal heirs.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

__________ at Zamboanga City.

____________
SIGNED IN THE PRESENCE OF:

__________________________ _________________________

ACKNOWLEDGEMENT
Republic of the Philippines}
City of ____________}S.S.

BEFORE ME, a Notary Public, in and for the City of ____________ on

___________ 2018, personally appeared ____________ who exhibited her competent
evidence of identity _________________ issued on _________________ at
____________________, and is known to me to be the same person who executed the the
same as an act of her free will and deed.

WITNESS MY HAND AND NOTARIAL SEAL on the date and place first above
written.