REPUBLIC OF THE PHILIPPINES )

Province of Leyte )
Municipality of Villaba ) S.S.
x---------------------------------------------x

AFFIDAVIT OF OWNERSHIP

I, EULITA B. SULIT, of legal age, Filipino, married, and a resident of Sitio

Mambajao, Brgy. Cagnocot, Villaba, Leyte, Philippines, after having been duly sworn
to in accordance with law, hereby depose and state, that:

1. That I am the owner and possessor of the following personal properties:

REFRIGERATOR
Brand –SHARP
Serial No. – 4616051404
Model No. LC – SJML80AS-SL

2. That above-described personal property is my possession;

3. That above-described property is free of any lien or encumbrance,

4. That this affidavit is executed to prove my ownership and possession and above-
described personal property.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 15th day of

January, 2018 at Villaba, Leyte, Philippines.

EULITA B. SULIT
Affiant
Voter’s ID No. 3751-0036A-I2452EBS20000
Issued On: _____________________________
Issued At: COMELEC, Villaba, Leyte

SUBSCRIBED AND SWORN to before me this 15th day of January, 2018 at Villaba,
Leyte, Philippines, affiant who is personally known to me and who exhibited her competent
evidence of identity indicated above.

Doc. No. ______;

Page No. ______;
Book No.______;
Series of 2018.