Affidavit For Change of Engineers & Architects

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Republic of the Philippines )

Province of Pampanga ) S .S.


Municipality of __________ )

AFFIDAVIT

I, ___________________________ of legal age, ___________________ and a


resident of ____________________________ after having been duly sworn to in
accordance with law do hereby depose and state:

1. That I am a registered Civil Engineer/ Architect/ Electrical Engineer with


PRC # ____________________________.
2. That I have actually supervised the construction / installation of
____________________________.
3. That I am liable and responsible for the stability of the said building for a
period of 15 years as stated in the National Building Code of the Philippines
(PD 1096).
4. That I am executing this affidavit to attest to the truthfulness of the foregoing
and to facilitate the issuance of a certificate of occupancy for the said
building.

AFFIANT SAYETH NONE:

__________________________
Affiant

Subscribed and Sworn to before me this _______ day of __________, 20 ____ at


____________________________: affiant exhibiting to me his/her Community Tax
Certificate No. ______________ issued at ___________________ on _______________.

_______________________
Notary Public
Until December 31, 20______
PTR No. ________________
Issued on ________________
Issued at _________________

Doc. No. ________;


Page No. ________;
Book No. ________;
Series of 20 ______.

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