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I, ____________________________________ , of legal age, married/single, and a
resident of __________________________________________________________________
after oath, hereby depose and say:

1. That I am an assignee/Rights Buyer of the mortgaged property of _________________,

a borrower of the National Home Mortgage Finance Corporation (NHMFC), with
Account No. ______________________ ;as evidenced by the attached duly notarized
Deed of Sale/Deed of Assignment;

2. That in order to avail of the benefits under RA9507 III, I am willing to abide by NHMFC's
conditions to formalize my assumption of the mortgage by completing the
requirements for Deed of Sale with Assumption of Mortgage (DOSAM) within 45 days;

3. That failure on my part to submit the complete requirements within the prescribed
period of 45 days, I interpose no objection to the proviso that any and all payments I
have tendered purportedly for RA9507 III shall be automatically treated as partial
payment/s only, without recourse to legal actions which NHMFC may initiate against
the mortgage;

4. That until the TCT of the property has been transferred in my name, which can only be
started after I have submitted the complete requirements for DOSAM, the Mortgage
Redemption Insurance shall be in the name of the borrower, provided he is of
insurable age or not over 65 years old;

5. That In the event of death of the original borrower and the MRI Pool find
inconsistencies in the Mortgage Redemption Insurance (MRI) coverage due to
unauthorized application made by a third party (other than the original borrower), and
subsequently deny MRI payment, I hold NHMFC free from any liability notwithstanding
the MRI payments/prepayments collected from me;

6. That in the event that the MRI Pool would later classify my coverage as substandard
and that there may be a need for an adjustment in the MRI premium, I am willing to
abide by the terms or pay the required additional payments.


SUBSCRIBED AND SWORN to before me this _______________________________

affiant exhibited his/her valid Government-issued ID No. ________________.

Doc. No. ____________

Page No. ___________
Book No. ___________
Series of 20_________.