REPUBLIC OF THE PHILIPPINES )

CITY OF D A V A O ) S.S.
x----------------------------------x

AFFIDAVIT OF EXPLANATION

I, MELODY PENELOPE Y. BATU, of legal age, Filipino, married to

Dean Manuel S. Gonzales and a resident of Gladiola, Buhangin, Davao City,
Philippines, after having been sworn to in accordance with law, hereby
depose and state that:

1. I intend to take the bar examinations in September 2002.;

2. In my Marriage Contract, my name was inadvertently entered as

MELODY P. BATU, when my true and correct name is MELODY PENELOPE Y.
BATU;

3. Likewise, the name of my mother in my Marriage Contract was

inadvertently entered as Esperanza Penelope when it should have been
Esperanza Yumang, which is her true and correct name. Attached
together with the Petition to take Bar Examinations is the certified true copy
of my Marriage Contract and original copy of my Birth Certificate;

4. The error in the entries in the Marriage Contract of my name and

the name of my mother was most probably due to inadvertence or mistake
on the part of the persons who prepared the same;

5. I am executing this affidavit to declare the foregoing facts and to

attest to the truth thereof and to inform and explain to the authorities
concerned the circumstances concerning the discrepancy relating to my
name and my mothers name and for whatever other legal purposes it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 10 th day of

July 2002 in the City of Davao, Philippines.

MELODY PENELOPE Y. BATU

Affiant

SUBSCRIBED AND SWORN to before me this 10TH day of July 2002 in

the City of Davao, Philippines affiant exhibiting to me her Community Tax
Certificate with No. 0695256 issued on July 9, 2002 at Davao City,
Philippines.

MARY FRANCIS A. MANUG

Notary Public
Until December 31, 2002
IBP No. 16080 12/28/02 d.c.
PTR No. 6275800 01/04/02 d.c.

Doc. No. 345;

Page No. 070;
Book No. II;
Series of 2002.
REPUBLIC OF THE PHILIPPINES )
C I TY OF D A V A O ) S.S.
x-------------------------------------------x

AFFIDAVIT OF DISCREPANCY

I, ELMA D. PINGOY-VANDER MAY, of legal age, Filipino,

married to Daniel Jay Vander May and a resident of 104 Psalm St., Villa Park
Cabantian, Davao City, Philippines, after having been sworn to in accordance
with law, hereby depose and state that:

1. I am the same Elma D. Pingoy-Vander May, an applicant for change

of family name (Due to Marriage) before the Department of Foreign Affairs-
Davao City;

2. When I submitted our marriage contract with the above-mentioned

office, I discovered that the place of birth indicated therein is Davao City
which is erroneous because I was born at Sayatan, Tublay, Benguet,
Philippines on July 16, 1959;

3. To prove the fact that I was born at Sayatan, Tublay, Benguet,

Philippines on July 16, 1959, I am attaching hereto as Annex A, a copy of
my birth certificate issued by the Office of the Local Civil Registrar of Tublay,
Benguet;

4. The error in the entry of my place of birth in our Marriage Certificate

was probably due to an inadvertent mistake on the part of the persons who
prepared the same;

5. I am executing this affidavit to declare the foregoing facts and to

attest to the truth thereof and to inform and explain to the authorities
concerned the circumstances concerning the discrepancy relating to the place
of birth entered in our marriage contract and for whatever other legal
purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this November

23, 2001 in the City of Davao, Philippines.

ELMA D. PINGOY-VANDER MAY

Affiant
SUBSCRIBED AND SWORN to before me this November 23, 2001 in the City of
Davao, Philippines. Affiant having exhibited before me her community tax certificate with
no. 02455556 issued on 7/04/01 at Davao City, Philippines.

Doc. No. 112 RAYMOND B. BATU

Page No. 24 Notary Public
Book No. IV Until December 31, 2002
Series of 2001. IBP No. 14570 12/29/2000 D.C.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x-------------------------------------------x

AFFIDAVIT OF DISCREPANCY

I, HERMINIA BATU CANTADA, of legal age, Filipino, married to Jose

Cantada, Jr. and a resident of Pag Asa Street, Buhangin, Davao City, Philippines, after
having been sworn to in accordance with law, hereby depose and state that:

1. I am the daughter of my late father HORTENCIO SAN JOSE BATU, who

died on May 31, 1994 at Davao City;

2. When I prepared and applied for a Passport with the Department of Foreign
Affairs, Davao City Office, I chanced upon my marriage certificate duly issued by the
Office of the Municipal Civil Registrar and I noticed a discrepancy in his family name since
his family name is listed therein as DATU and not BATU as his CORRECT family
name;

3. That the entry of his family name as DATU as reflected in our Marriage
Certificate is erroneous considering that his real family name is BATU, not only because
of the fact that the name BATU is the one registered with the Civil Registrar but also
because he has been using the family name BATU since childbirth up to his death;

4. The error in the entry of my fathers family name in our Marriage Certificate was
most probably due to inadvertence or mistake on the part of the persons who prepared the
same;

5. I am executing this affidavit to declare the foregoing facts and to attest to the
truth thereof and to inform and explain to the authorities concerned the circumstances
concerning the discrepancy relating to my fathers family name and for whatever other
legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of October,

2001 in the City of Davao, Philippines.

HERMINIA BATU-CANTADA
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October 2001 in the
City of Davao, Philippines.

Doc. No. ___;

Page No. ___;
Book No. I;
Series of 2001.
Republic of the Philippines]
C I T Y OF D A V A O ] s.s
******************
AFFIDAVIT

I, SUSAN L. TRIPOLE, of legal age, married to Jose M.

Tripole and a resident of Davao City, Philippines, after having
been sworn to in accordance with the law, do hereby depose and
state that:

1. I am the mother of JESSA MEIKO L. TRIPOLE, who was

born on July 18, 1998;

2. The my husband, Jose M. Tripole and the father of Jessa

Meiko L. Tripole is presently in Japan;

3. I intend to travel abroad alone leaving my daughter,

Jessa Meiko L. Tripole, in the custody and care of my
sister Alicia L. Angsingco of 288-A, Ponce St., Davao
City;

4. I give my consent for my sister Alicia L. Angsingco to be

the GUARDIAN of my daughter during the time I am
away in another country;

5. I shall continue giving financial support to my daughter;

6. Alicia L. Angsingco has signified to me her utmost desire

to take care of my daughter and act as her GUARDIAN,
the former being my sister and loving auntie of my
daughter;

7. I am executing this affidavit to attest to the truth of the

foregoing statements and for whatever legal purpose it
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my

signature this ___________ in the City of Davao, Philippines.

SUSAN L. TRIPOLE
Affiant

SUBSCRIBED AND SWORN to before me this

______________ in the City of Davao, Philippines, affiant having
exhibited to me her Community Tax Certificate No. _________
issued on ______________ at ___________.
Doc. No.
Page No.
Book No. IV;
Series of 2001
Republic of the Philippines]
CITY OF D A V A O ] s.s
*******************
AFFIDAVIT

I, GLORIA C. LABELLA, Filipino, of legal age, married and a resident of

3300 Times Beach, Manggahan, Davao City, after having been sworn to in
accordance with the law, do hereby depose and state that:

8. I am a plain housewife with no means of income;

9. I am depending on my children, who are all working at Manila, for

financial support;

10. For the reason that I am not employed and not earning anything, I did
not apply with the Bureau of Internal Revenue a Tax Identification
Number (TIN);

11. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of August, 2000 in the City of Davao, Philippines.

GLORIA C. LABELLA
Affiant
SUBSCRIBED AND SWORN to before me this 9TH day of August, 2000
in the City of Davao, Philippines, affiant having exhibited to me her Community
Tax Certificate No. 00952036 issued on August 4, 2000 in Davao City.

Doc. No. 333;

Page No. 68;
Book No. II;
Series of 2000.
Republic of the Philippines]
CITY OF D A V A O ] s.s
*******************
AFFIDAVIT

I, POTENCIANO Q. CENIZA, Filipino, of legal age, married and a

resident of 404 Gladiola St., Buhangin, Davao City, after having been sworn to in
accordance with the law, do hereby depose and state that:

12. I am the father of the late Neil L. Ceniza who passed away last June
14, 2000;

13. The reason for his untimely death was due to a vehicular
accident/collision, which involved my son Neil L. Ceniza, on June 14,
2000 at 5:30 p.m. at Catalunan Pequeo, Davao City;

14. My son was a holder a valid Non-Professional License issued by the

LTO and during the above-mentioned date he was driving a car,
owned by one Susan Deiparine;

15. After the accident, we discovered that almost all his personal
belongings, car tools, computer spare parts and car accessories were
already gone and could have been taken by somebody interested on
such belongings;

16. One of the personal belongings that got lost was his wallet which
contained important documents such as his passport and the non-
professional drivers license;

17. Despite diligent efforts to locate his important belongings, car tools,
car accessories, computer spare parts, his Philippine Passport and his
Non-Professional Drivers License, the same proved to be a futile
exercise;

18. The personal belongings, car accessories, computer spare parts, car
tools, Philippine Passport and Non-professional Drivers License
should all be declared lost for all intents and purposes;

19. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8TH

day of August, 2000 in the City of Davao, Philippines.

POTENCIANO Q. CENIZA
Affiant
SUBSCRIBED AND SWORN to before me this 8TH day of August, 2000
in the City of Davao, Philippines, affiant having exhibited to me his Community
Tax Certificate No. 00913533 issued on June 22, 2000 in Davao City.

Doc. No. _____;

Page No. _____;
Book No. II;
Series of 2000.
Republic of the Philippines]
CITY OF D A V A O ] s.s
*******************

AFFIDAVIT

I, ENERIE B. AQUINO, Filipino, of legal age, widow and a resident of

158-A J.P. Cabaguio Avenue, Davao City, after having been sworn to in
accordance with the law, do hereby depose and state that:

20. I am the wife of the late Miguel T. Aquino who passed away last July
05, 1999. A copy of his certificate of death is hereto attached as Annex
A;

21. One of the property registered in my late husbands name is the M. T.

AQUINO bldg., located at corner Cabaguio and Bolcan St.,, Davao
City;

22. Door no. 5 of the M. T. AQUINO bldg. has no water connection yet
and the same is still under application before the Davao City Water
District;

23. I am requesting the Davao City Water District that the water billing be
made and reflected under my name-ENERIE B. AQUINO;

24. I am executing this affidavit to attest to the truth of the foregoing

statements and to request the Davao City Water District for a water
connection at Door no. 5 M. T. AQUINO bldg., corner
Cabaguio and Bolcan St.,, Davao City, and that the water billing
be reflected under my name.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of August, 2000 in the City of Davao, Philippines.

ENERIE B. AQUINO
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of August, 2000

in the City of Davao, Philippines, affiant having exhibited to me her Community
Tax Certificate No. 05710444 issued on January 18, 2000 in Davao City.

Doc. No. _____;

Page No. _____;
Book No. II;
Series of 2000.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x-------------------------------------------x

AFFIDAVIT of EXPLANATION
I, ERMELITA RENICO CAMU-MILITANTE of legal age, Filipino, married
and a resident of Talomo Teachers Village, Davao City, Philippines, after having been
sworn to in accordance with law, hereby depose and state that:
1. I am the same Ermelita Renico Camu-Miltante who was born on October 21,
1964 to spouses Ermito Camu and Lolita Resco Renico;
2. My birth is registered in the Local Civil Registrar of Makati with no. 2710;
3. The family name of my mother is RENICO and she was born at Concepcion,
Malabon, Metro Manila . A copy of her certificate of live birth is hereto
attached as Annex A to prove such fact;
4. However, the following discrepancies appeared in my Certificate of Live Birth,
hereto attached as Annex B, regarding my middle name as well as the last
name of my mother, to wit:
a. My middle name was reflected therein as RESCO instead of RENICO
which is my true last name;
b. The middle name and last name of my mother was interchanged, hence, the
last name that was reflected therein was RESCO and not RENICO which
is the true last name of my mother;

5. The errors in my Certificate of Live Birth were due to inadvertence or mistake

on the part of the persons who prepared the same;
6. I am executing this affidavit to declare the foregoing facts and to attest to the
truth thereof and to inform and to explain to the authorities concerned the
circumstances as to the discrepancies appearing in my Certificate of Live Birth
and for whatever other legal purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of August,
2000, in the City of Davao, Philippines.

ERMELITA RENICO CAMU-MILITANTE

Affiant
SUBSCRIBED AND SWORN to before me this 3rd day of August, 2000 in the
City of Davao, Philippines, affiant having exhibited to me her Community Tax Certificate
No. 00950296 issued on August 1, 2000 in Davao City.

Doc. No. _____;

Page No. _____;
Book No. II;
Series of 2000.
REPUBLIC OF THE PHILIPPINES )
C I T Y O F D A V A O ) S.S.
x---------------------------x

AFFIDAVIT

I, BEVERLY W. SALCEDO, of legal age, Filipino, married

and a resident of Davao City, Philippines, after having been
sworn to in accordance with law, hereby depose and state
that:

1. I am the wife of RODELIO P. SALCEDO;

2.A petition for the adoption of MIRAFEE W. SALCEDO,

will be filed by the undersigned before the Regional Trial
Court;

3. As of the moment, my husband Rodelio P. Salcedo who

is working abroad cannot be available due to the nature
of his work;

4.I hereby give my consent to the adoption of MIRAFEE

W. SALCEDO;

5.I am executing this affidavit to declare the

foregoing facts and to attest to the truth and inform the
school authorities concerned.

IN WITNESS WHEREOF, I have hereunto set my hand this

14th

day of March, 2000 in the City of Davao, Philippines.

BEVERLY W. SALCEDO
Affiant

SUBSCRIBED AND SWORN to before me this 14th day of

March, 2000 in the City of Davao, Philippines, affiant
having exhibited to me her Community Tax Certificate No.
00365658 issued on January 5, 2000 at Davao City.

Doc. No. ___;

Page No. ___;
Book No. VI;
Series of 2000.

REPUBLIC OF THE PHILIPPINES )

CITY OF D A V A O ) S.S.
x-------------------------------------------x

AFFIDAVIT of EXPLANATION
I, ERMITO RENICO CAMU, JR. of legal age, Filipino, married and a resident
of Talomo Teachers Village, Davao City, Philippines, after having been sworn to in
accordance with law, hereby depose and state that:
7. I am the same Ermito Renico Camu Jr. who was born on September 15, 1959
to spouses Ermito camu and Lolita Resco Renico;
8. My birth is registered in the local civil registrar of Manila with no. 6459 (159);
9. The family name of my mother is RENICO and she was born at Concepcion,
Malabon, Metro Manila . A copy of her certificate of live birth is hereto
attached as Annex A to prove such fact;
10. However, the following discrepancies appeared in my Certificate of Live Birth,
hereto attached as Annex B, regarding my middle name as well as the last
name of my mother, to wit:
c. My middle name was reflected therein as RESCO instead of RENICO
which is my true last name;
d. The middle name and last name of my mother was interchanged, hence, the
last name that was reflected therein was RESCO and not RENICO which
is the true last name of my mother;
e. Moreover, the birthplace of my mother was incorrectly entered therein as
being born at Kalibo, Aklan when the truth for the matter, her certificate of
live birth shows that she was born at Concepcion, Malabon, Metro Manila;
f. That my mother signed in my Certificate of Live Birth as Lolita Resco
thinking that she should sign only on what appears on the Certificate of
Live Birth-which was Lolita Resco only;
11. The errors in my Certificate of Live Birth were due to inadvertence or mistake
on the part of the persons who prepared the same;
12. I am executing this affidavit to declare the foregoing facts and to attest to the
truth thereof and to inform and to explain to the authorities concerned the
circumstances as to the discrepancies appearing in my Certificate of Live Birth
and for whatever other legal purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 2nd day of August,
2000, in the City of Davao, Philippines.

ERMITO RENICO CAMU, JR.

Affiant
SUBSCRIBED AND SWORN to before me this 2nd day of August, 2000 in the
City of Davao, Philippines, affiant having exhibited to me his Community Tax Certificate
No. 00897471 issued on July 21, 2000 in Davao City.

Doc. No. _____;

Page No. _____;
Book No. II;
Series of 2000.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x-------------------------------------------x

AFFIDAVIT

I, SPO3 BONIFACIO J. CASTRO, of legal age, married, Filipino,

and a resident of Blk. 14, Lot 6. Kadayawan Homes, Bangkal, Davao
City, Philippines, after having been sworn to in accordance with law,
hereby depose and state

1. That I am a member of the Philippine National Police (PNP)

assigned at PP3 Talomo, Davao City;

2. That my wife, Mrs. Jussie Castro, is presently employed at

CENRO, City Hall, Davao City receiving a monthly salary of Eight
Thousand Pesos (P8,000.00) plus additional income from Rice
Farming and Public Utility Jeepney rental amounting to Sixty Seven
Thousa

nd pesos (P67,000.00) per month; with a TOTAL income of Seventy-

Five Thousand Pesos (P75,000.00) per month;

3. That I am applying for a loan with AFPSLAI and I am capable

to pay the said loan.

4. That I am executing this affidavit to attest to the truth of the

foregoing facts aforestated. and for whatever other legal purposes it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7th

day of June, 1999 in the City of Davao , Philippines.

SPO3 BONIFACIO J. CASTRO

Affiant

SUBSCRIBED AND SWORN to before me this 7th day of June ,

1999 in the City of Davao, Philippines, affiant having exhibited to me
his Community Tax Certificate No. CCII997 15948989 issued on
January 29, 1999 in Davao City.

ATTY. ISRAELITO P. TORREON

Notary Public
Until December 31, 1999
IBP No. 464523 - 12/29/98 D.C
PTR NO. 3948898 - 01/05/99 D.C.

Doc. No. 217;

Page No. 44;
Book No. II ;
Series of 1999.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x-------------------------------------------x

AFFIDAVIT OF DISCREPANCY

I, ROMEO T. FAJARDO, of legal age, Filipino, single and a resident of Davao

City, Philippines, after having been sworn to in accordance with law, hereby depose and
state that:

1. I am the eldest son of my late father - JOSELITO M. FAJARDO, who died on

May 1, 1999 at Davao City;

2. When I prepared the papers for his Social Security System (SSS) claim, I
chanced upon his records with the SSS and I noticed a discrepancy in his name since his
name is listed therein as JOSE and not JOSELITO as his name appears in his
Certificate of Live Birth;

3. That the entry of his name as JOSE with the Social Security System is
erroneous considering that his real name is JOSELITO, not only because of the fact
that the name JOSELITO is the one registered with the Civil Registrar but also because
he has been using the name JOSELITO since childbirth up to his death;

4. The error in the entry of my fathers name with SSS was most probably due to
inadvertence or mistake on the part of the persons who prepared the same;

5. I am executing this affidavit to declare the foregoing facts and to attest to the
truth thereof and to inform and to explain to the authorities concerned the circumstances
concerning the discrepancy relating to my fathers name as the same appears in his SSS
records as compared with his name JOSELITO in his Certificate of Live Birth and for
whatever other legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this __th day of May,
1999, in the City of Davao, Philippines.

ROMEO T. FAJARDO
Affiant

SUBSCRIBED AND SWORN to before me this _th day of May, 1999 in the City
of Davao, Philippines, affiant having exhibited to me his Community Tax Certificate No.
16003492 issued on February 16, 1999 in Davao City.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 1999.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x-------------------------------------------x

JOINT AFFIDAVIT OF BIRTH

I, ROMEO T. FAJARDO, of legal age, Filipino, single and a resident of Davao

City, Philippines, after having been sworn to in accordance with law, hereby depose and
state that:

1. I am the eldest son of my late father - JOSELITO M. FAJARDO, who died on

May 1, 1999 at Davao City;

2. When I prepared the papers for his Social Security System (SSS) claim, I
chanced upon his records with the SSS and I noticed a discrepancy in his name since his
name is listed therein as JOSE and not JOSELITO as his name appears in his
Certificate of Live Birth;

3. That the entry of his name as JOSE with the Social Security System is
erroneous considering that his real name is JOSELITO, not only because of the fact
that the name JOSELITO is the one registered with the Civil Registrar but also because
he has been using the name JOSELITO since childbirth up to his death;

4. The error in the entry of my fathers name with SSS was most probably due to
inadvertence or mistake on the part of the persons who prepared the same;

5. I am executing this affidavit to declare the foregoing facts and to attest to the
truth thereof and to inform and to explain to the authorities concerned the circumstances
concerning the discrepancy relating to my fathers name as the same appears in his SSS
records as compared with his name JOSELITO in his Certificate of Live Birth and for
whatever other legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this __th day of May,
1999, in the City of Davao, Philippines.

ROMEO T. FAJARDO
Affiant

SUBSCRIBED AND SWORN to before me this _th day of May, 1999 in the City
of Davao, Philippines, affiant having exhibited to me his Community Tax Certificate No.
16003492 issued on February 16, 1999 in Davao City.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 1999.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x-------------------------------------------x

A F F I DA V I T of E X P LA N A T I O N

I, GINA MARAVILLAS MILAN, of legal age, Filipino, married and a resident of 183
Executive Homes, Matina, Davao City, Philippines, after having been sworn to in accordance with
law, do hereby depose and state that:

1. Sometime in June, 1999 I filed an application for a passport at the Department of

Foreign Affairs - Manila, through the assistance of Starflight Fame Corporation, a travelling
agency registered under existing laws;

2. I gave all the necessary papers, documents, fees and other requirements to a certain Mr.
Villamor, who was the former liason officer of Starflight Fame Corporation;

3. I learned later from the said travelling agency that the said Mr. Villamor went on
Absence Without Official Leave (AWOL) and did not hear from him anymore;

4. When Mr. Villamor left the travelling agency without official leave, he has in his
posession my application for a passport, pertinent papers and documents, and even the processing
fee I paid for said passport application;

5. I went back to Davao City and on September 17, 1999, I applied for a NEW passport
before the DFA-Davao City thinking that Mr. Villamor did not process my application at DFA-
Manila and in the belief that he just squandered the money I and the other applicants gave him;

6. I learned later from DFA-Davao that a passport was already issued in my name on July
16, 1999 with passport no. E706047;

7. I did not receive and it is not in my possession the above-mentioned passport, and I
further declare that I do not have in my posession any passport issued by the Department of
Foreign Affairs;

8. I am executing this affidavit to attest to the truth of the foregoing facts and to inform
and to explain to the authorities concerned the circumstances why I do not have with me the
passport issued in my name on July 16, 1999 by the DFA-Manila and why I applied for a NEW
passport before the DFA-Davao City, and for whatever other legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 27th day day of September,
1999, in the City of Davao, Philippines.

GINA M. MILAN
Affiant

SUBSCRIBED AND SWORN to before me this 27 day of September, 1999 in the City of
Davao, Philippines, affiant having exhibited to me her Community Tax Certificate No. 04507351
issued on September 10, 1999 in Tagum City, Philippines.

Doc. No. _____;

Page No. _____;
Book No. I;
Series of 1999.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S
x------------------------/
AFFIDAVIT
I, HAZEL U. OSORIO, of legal age, Filipino, single and a resident of Blk. 4, Lot
24, San Juan Village, Bangkal, Davao City, Philippines, after having been sworn to in
accordance with the law, do hereby depose and state that:
1. I am employed as a Clinical Coordinator of Baxter Healthcare Phil., Inc., with
business address at 5th floor, Narra Building, 2776 Chino Roces Ave., Makati;
2. I am presently assigned in Davao City, Philippines and relative to my
function I was issued a KIA pride sedan by the company. The said car is particularly
described as follows:

Make : Kia
Series : Pride
Type : Sedan
Motor No. : B1513541
Serial/Chassis : KNJCA115XNS007078
Model : 96
Color : White
Plate no. : UGU 631
3. Sometime in the last week of October 1999, at around 8:30 in the morning, I
was driving the above-mentioned car from our house at Bangkal, Davao City and while
executing a right turn at the corner of Block 3 and Block 2 of San Juan Village, Bangkal,
Davao City, the above-mentioned vehicle fell on a canal landing on its right side
portion;
4. Because of such, the right side portion and the lower middle portion of the
vehicle suffered damage (dents). Pictures of the said car are hereto attached as Annex
A to prove the said allegations;
5. Sometime in the first week of November 1999, While I was driving and
maneuvering the above-mentioned car at the garage of our house at Bangkal, Davao
city, its left side portion hit the railings of the gate;
6. The car incurred damage (dents) on its left side portion. Pictures of the left
side portion of the car is hereto attached as Annex B to prove the said allegations;
7. I am executing this affidavit to declare the foregoing facts and to attest to the
truth thereof and to inform and to explain the circumstances concerning the dents or
damage on the said car. The same is executed also for whatever other legal purposes it
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 8th day of
December, 1999, in the City of Davao, Philippines.

HAZEL U. OSORIO
Affiant
SUBSCRIBED AND SWORN to before me this 8th day of December, 1999 in the
City of Davao, Philippines, affiant having exhibited to me his Community Tax
Certificate No. 05698592 issued on December 8, 1999 in Davao City.

Doc. No. 160

Page No. 32
Book No. I
Series of 1999.