REPUBLIC OF THE PHILIPPINES )

______________________________) S.S.

AFFIDAVIT OF PARAPHERNAL/SEPARATE PROPERTY

I, FOREIGN HUSBAND, _______________ citizen, of legal age and residing

at ______________________________________, after having duly sworn in
accordance with law, hereby depose and state, that:—

1. I am legally married to FILIPINA WIFE, of legal age, Filipino,

and with address at ____________________________________
_________________, Philippines.

2. My spouse purchased a property consisting of Two Hundred

(200) Square Meters located at ___________________________
_______________________________, and covered by Transfer
Certificate of Title (“TCT”) No. 12459 of the Registry of Deeds
for Antipolo City (“Property”) from its registered owners.

3. The funds used to purchase the abovementioned property do not

form part of our absolute community of property but were taken
from the personal/ paraphernal/ separate funds of my spouse.

4. I hereby affirm and recognize the exclusive rights of my spouse

to acquire, sell, mortgage, encumber, alienate and/or otherwise
dispose of said property in the exercise of her sole ownership of
the same.

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

foregoing and for all legal intents and purposes.

DONE, this _____ day of __________________ at ______________________.

FOREIGN HUSBAND
Affiant

SUBSCRIBED AND SWORN to before me this _________________, in

___________________, affiant exhibiting to me his Passport No. _______________
issued by , valid until _______________.

NOTARY PUBLIC

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 201__.