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I_ _____________________________________
say :
That I am one of the adjoining owners of lot bounded on the ____ _ of the lot owned by __ ___ with Tax Declaration No. ___and Lot No. _ _ located at _
__ .
That ___ ___ owned the said lot above and has continous possession for over a period of FIVE(5) years.
__ day of _
2012.
_ _ Adjoining Owner
SUBSCRIBE AND SWORN TO BEFORE ME, this _________ day of ___________ , 2012 at _________ _ _____ _,Philippines. The affiant exhibited before me this Community Tax Certificate No. _______________ ,Issued on _ __________________ __ at _ ________________________ _.