REPUBLIC OF THE PHILIPPINES}

CITY OF ________________ } S.S

AFFIDAVIT

I, xxx, of legal age, married to xxx, Filipino, and a resident of xxx, after being
sworn in accordance with law, hereby deposes and says that:
1.) I am a co-owner of a business establishment, registered under the name of my
husband, with the business name, “xxx”;
2.) Because of the worsening economic condition and the lack of sufficient funds to
sustain its operation, we were propelled to close the said business;
3.) We have obtained a “Certification of Foreclosure” from the Office of the City of
__________, but we have lost it and can no longer find it despite diligent effort such
that it is now lost beyond recovery;
4.) We tried to secure another certification from the Office of the City of __________,
but they also refused to furnish us with another copy;
5.) I am executing this affidavit to attest to the veracity of the foregoing facts and to
support the application for the issuance of a new one in lieu of the one which was
lost.
IN WITNESS HEREOF, affiant affixed her signature this August __, 2018 at the
City of __________, Philippines.

xxxx
Affiant
ID No:
Issued by:

SUBCRIBED AND SWORN TO before me this September __, 2018,

__________,, Bukidnon, Philippines, affiant exhibited to me her valid identification as
proof of her identity.

Doc No. ________;

Page No. ________;
Book No. ________;
Series of 2018.