Republic of the Philippines)

City of Z A M B O A N G A ) S.S.

AFFIDAVIT

I, BRIAN M. CLIMACO, of legal age, married, Filipino and with residence at

Tugbungan, Zamboanga City, Philippines, after being duly sworn with law, depose and state

That I am the authorize Driver and registered in the name of FELECISIMO D. OPIÑA,
of the following described motor vehicle, to wit:

Model: MITSUBISHI XPANDER GLS SPO

Color: WHITE PEARL
Plate number: JAC7892
Certificate of Registration No.: 348236103/08-02-2019-LTO Quezon City
Official Receipt: 1543405953/08-01-2019-LTO Quezon City

1. That on or about 6:00 o’clock in the evening of December 16 ,2019, As I was

driving the car along Bougainvillea Drive, Guiwan, Zamboanga, it accidentally grazed a
house fence, scrapping the front FR Bumper Assy and FR Airdam Assy of the car causing
dents and scrapping the paint to the said motor vehicle.

2. As it was an accident solely caused by me, I did not summon nor report the said
incident to the police officer. Thus, no record of the said accident is in file of the police or
any persons in authority.

3. Likewise, the said accident was not due to any neglect or lack of skill on my part or it
was made with any malicious intent.

4. I am executing this affidavit in order to attest to the truth of the foregoing

circumstance and for the purpose of reporting such matter to my insurance company for
insurance claims.

IN WITNESS WHEREOF, I have hereunto set my hand on the date and place hereinafter
mentioned.

BRIAN M. CLIMACO
Affiant

SUBSCRIBED AND SWORN to before me on this _______ of December, 2019 at

Zamboanga City, Philippines. Affiant having exhibited to me his Non-Professional Driver’s License
No. J01-14-000203 valid until 2022/04/04 issued at LTO Zamboanga City.

ATTY. JAN CEASAR A. CLIMACO

Doc. No. 329; Notary Public for Zamboanga City
Page No. 67; Until December 31, 2020
Book No. 12;
CASTILLO & CLIMACO
Series of 2019.
Grnd Flr. Mendoza Bldg., Pilar St., Z.C.
IBP No. 059425 / Jan. 9,2019 / Z.C.
PTR No.1825482 / January 4, 2019 / Z.C.
Attorney’s Roll No. 67048
MCLE- Compliance No.VI-0014578
Republic of the Philippines)
City of Z A M B O A N G A ) S.S.

AFFIDAVIT OF LANDHOLDING AND NON-TENANCY

We, the BRIAN M. CLIMACO, married to Charisse M. Opiña, both legal age, Filipinos
and residents of Tugbungan, Zamboanga City, Philippines, after being duly sworn, depose and say:

That we are the vendees of that Three Thousand Three Hundred Ninety Four (3,394)
Square Meters, A parcel of land ( LOT 577-B-1) of the subdivision plan, Psd-09-054684, being
a portion of Lot 577-B (LRC) PSD-63465, situated in the Barangay of Cabaluay, City of
Zamboanga, presently covered by Transfer Certificate of Title No. T- 129-2012002094 having
acquired by virtue of that Deed of Absolute Sale, executed on November 6, 2019 before Notary
Public Jan Ceasar A. Climaco, of Zamboanga City and entered as Doc. No. 260; Page No. 53;
Book No. 13; Series of 2019;

That, aside from the landholding we acquired as afore-mentioned, we do not own any other
landholding and the same do not exceed the landholding as provided by law ;

That said parcel of land is an ordinary agricultural land and devoted to some coconut trees
and banana plants and the same is not tenanted as it was taken care of and cultivated by the
Transferor themselves;

That we are executing this affidavit to attest to the truth of the foregoing narration of facts
for the purpose herein mentioned and in compliance with the provisions of the Comprehensive
Agrarian Reform Law of 1988;

IN WITNESS WHEREOF, we have hereunto set our hands on the date and place
hereinafter mentioned.

BRIAN M. CLIMACO CHARISSE M. OPIÑA

Affiant Affiant

SIGNED IN THE PRESENCE OF :

_____________________ ____________________

Republic of the Philippines)

City of Z A M B O A N G A ) S.S.
X-------------------X
BEFORE ME , a Notary Public for Zamboanga City, on this ______day of _______,
20____, came the parties with their IDs, to wit :

Brian m. Climaco-
Charisse m. Opiña-

known to me and to me known to be the same persons who executed the foregoing instrument and
acknowledge the same is their own free acts and deeds.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 20___.

Copy furnished:
The Barangay Agrarian Reform Council
Barangay of Cabaluay, Zamboanga City
c/o The Punong Barangay
Registry Receipt No. ______________