Sample Conformity

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Republic of the Philippines )

Province of Cagayan ) s.s.


City of Tuguegarao )

AFFIDAVIT OF CONFORMITY

I, ______________________, of legal age, Filipino citizen, single and a


resident of ________________________, after having been duly sworn to in
accordance with law, do hereby depose and state under aoth that-

1. I am the one and same person reffered to as the land owner/claimant of the
Lot No. C being a portion of Lot No. __________________, containing an
area of __________________ square meters, more or less;

2. I am the true and lawful land owner/claimant of the above-described lot with
the particular technical description as verified and certified by the Chief,
Regional Surveys and Mapping Division of the Department of Environment
and Natural Resources (DENR);

3. The parcel of land mentioned in the precceding paragraph is subject for the
appplication of road right of way, thus, I conform to such endeavor being the
true and lawful land owner of the same. I am giving a portion of my lot
containing _______________ meters as a ;

4. I am executing this affidavit to attest to the truthfullness of the foregoing


facts and for whatever purpose or legal intents it may serve.

Further affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day of June 2015, at
Tuguegarao City, Cagayan.

___________________________
Affiant

SUBSCRIBED AND SWORN to before me this this 17th day of June 2015, at
Tuguegarao City, Cagayan.

Doc. No. _________


Page No. _________
Book No. _________
Series of 2015.

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