REPUBLIC OF THE PHILIPPINES )

Municipality of Talibon
) S.S.

AFFIDAVIT OF CONSENT
I, _____________, Filipino, of legal age, and a resident of ________________, Philippines, having
been duly sworn in accordance with law, hereby depose and state:
1. That I am one of the heirs of Spouses ________________ who owned a parcel of land with
TD No. ___________;
2. That my sister _____________ is applying for a Building Permit at the Office of the MPDC of
the Municipality of __________ so she could build a residential house on a portion of the
aforementioned parcel of land;
3. That I hereby signify my written consent, freely, willingly and voluntarily to allow my sister
______________ to build her residential house on a portion of the said parcel of land and,
consequently, have an electric connection on her house;
4. That I am executing this affidavit to attest the truth of the foregoing facts as to my
undertaking to give consent to my sister ______________ to support her application for a
Building Permit and Electrification Permit.
IN WITNESS WHEREOF, we have hereunto set our hands this 13 th day of April 2015 at
________________, Philippines.

___________________
Affiant
SUBSCRIBED AND SWORN to before me, this 13th day of April 2015 at ____________________.