Republic of the Philippines )

) s.s.
x----------------------x

AFFIDAVIT OF ACKNOWLEDGMENT OF DEBT AND UNDERTAKING

I, EMILY N. LIBO-ON, of legal age, Filipino, single and a resident of Brgy.

Kirayan Tacas, Miagao, Iloilo, after having been duly sworn to in accordance with law,
hereby depose and state that:

1. I borrowed from CYNTHIA F. SEALZA, a resident of Brgy. San Rafael, Miagao,

Iloilo, an amount of FORTY THOUSAND PESOS (P40,000.00) on January 23,
2019.

2. I received said amount on the same date.

3. I undertake to pay her within a period of three months from January 23, 2019, or
on or before April 23, 2019.

4. I am executing this affidavit for whatever legal purpose this may serve me or
Cynthia F. Sealza, and/or our heirs, successors-in-interest, and assigns.

5. I have read this affidavit and I understand the statements contained herein and
the same are all true and correct of my personal knowledge.

IN WITNESS WHEREOF, I have hereunto set my hand this 8th day of February
2019 in Miagao, Iloilo.

EMILY LIBO-ON
Affiant

SUBSCRIBED AND SWORN TO before me this 8th day of February 2019 in

_________________________, affiant personally appeared before me and exhibited to me
her competent evidence of identity this being her Voter’s ID with number VIN 3030-
0131A-K0767ENL20000 issued by the Commission on Elections.