City of Zamboanga ) S.

S

AFFIDAVIT OF OWNERSHIP WITH CIRCUMSTANCE

I, THELMA B. CORTEZ of legal age, Filipino, married to EMILIANO CORTEZ and resident
of 647 Canelar St., Zamboanga City, after having been duly sworn to in accordance with law, do hereby
depose and say that:

1. I am the owner of CTD Number 2371, issued by the closed Rural Bank of Sebaste (Antique),
Inc. (RBSI);
2. Since the date of opening of the said CTD Number 2371 and up to the present, I have been in
possession of the said accounts and there is no conflict or dispute arising from my ownership and
possession of the same;

3. I have right over the same, as well as control and dominion thereof;

4. I am not indebted to the bank wither as principal borrower, co-maker, guarantor or surety for any
debt nor do I have any money or property accountabilities to bank;

5. In addition to liabilities, civil or criminal that may arise therefrom, I am willing to refund the
amount that will be paid to me and indemnify Philippine Deposit Insurance Corporation (PDIC)
and/or third parties for any loss or damages should PDIC discover later that I have made
misrepresentations in any claim form or sworn statement/ Affidavit I previously executed relative to
the above-mentioned deposit account, or in this Affidavit and in the supporting documents I have
submitted. I am fully aware that I may be prosecuted for perjury and/or other offenses punishable
under the Revised Penal Code and/or Special Laws for any misrepresentation made in this Affidavit
and /or its supporting documents;

6. I am expressly waiving and/or renouncing any right and/or privilege that I have or may have by
reason of the provisions of the Law on Secrecy of Bank Deposits (Republic Act No. 1405_ and
hereby authorize the PDIC and/or the Banko Sentral ng Pilipinas (BSP), and or their duly authorized
representatives, to open, examine and conduct investigation on my above-mentioned account with
RBSI. I am likewise authorizing the BSP and the PDIC, and their duly authorized representatives to
use any information from said account in any action before any court, tribunal and/or administrative
agency;

7. I am willing to further attest to the validity of said deposit in other related investigations or be a
witness in court to testify to the truthfulness of my representations;

8. The amount deposited in the above-stated account comes from the interest earned from my other
bank accounts in Zamboanga City;

8. I am executing this affidavit voluntarily and without any mental reservation to attest to the truth
and veracity of the above statements and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my signature this ______ day of ___________
2008 at __________________________.

THELMA A. CORTEZ
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this ______ day of ___________________,
in the City of _______________________ by the affiant who has satisfactorily proven her
______________________ / ___________________ that she is the same person who personally signed
the foregoing affidavit before me and acknowledged that she executed the same. I FURTHER
CERTIFY that I have personally examined the affiant and she acknowledged to me that she has read and
understood the contents of the affidavit and I am satisfied that the affiant voluntarily executed the same.

Doc. No. _______;
Page No. _______;
Book No. ______;
Series of 2008