REPUBLIC OF THE PHILIPPINES )

Province of Leyte ) S.S.

Municipality of Villaba )
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AFFIDAVIT OF OWNERSHIP
I, BELEN P. LIBORES, of legal age, Filipino, married, and a resident of Brgy. Inangatan,
Tabango, Leyte, Philippines, after having been duly sworn to in accordance with law, hereby
depose and state that:

1. I am the true and absolute owner and possessor of the following personal
properties, to wit:

ONE (1) WASHING MACHINE ONE (1) HUG DVD PLAYER

Brand-. Panasonic Serial No.-382014009130987
Serial No.: 5721131818

ONE (1) VJL AMPLIFIER ONE (1) DEVANT TV

Serial No.-AZ230V/60HZ Serial No.-T838S35/AG09

ONE (1) VJL SPEAKER

Serial No.- JCVGLPT-X12201/310/10173

2. The above-described personal properties are in my possession and are free of any
lien or encumbrance;

3. That I hereby warrant title and ownership over the above-mentioned personal
properties;

4. That I execute this Affidavit of Ownership to attest to the truth of the

aforementioned facts and in support of my loan renewal application with Palompon
Community Multi-Purpose Cooperative Incorporated (PACCI) and for any other
legal purposes that this Affidavit could serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 21st day of May,
2019 at Villaba, Leyte, Philippines.

BELEN P. LIBORES
Affiant

SUBSCRIBED AND SWORN to before me, this 21st day of May, 2019 at Villaba, Leyte, by the
Affiant who is personally known to me (or whom I have identified through competent evidence of
identity) and who exhibited her ID No. L5-14-8333 issued at Villaba, Leyte, Philippines.