REPUBLIC OF THE PHILIPPINES

CITY OF LAOAG
) S.S.

AFFIDAVIT
I, JENYFLOR GLORIA H. SANTOS, of legal age, single, Filipino and a resident
of 6 DL Giron St. Brgy 7-B Laoag City, Philippines, after having been duly sworn to in
accordance with law, hereby depose and say that:
1. I am a payor of the irrigation services fee at the NIA-INIMO involving a parcel of
land designated as lot nos. 16001, 16801, 16301, 16719, 16819, 17005 and 17008
situated at Brgy Vira, Laoag City.
2. However, upon careful scrutiny of real property records, I discovered that I do not
own, I do not admimnister, does not till or an heir of the above-described parcels of land
and might have been inadvertently included in my billings by the NIA and IA deputized
collectors;
3. In view thereof, i hereby request that the irrigation fees i paid for the said property
be transferred and applied to the property I own which is designated as lot nos. 16501,
16919, 17003 with an area of 1274 sqm, 759 sqm. and 436 sqm, respectively and covered
by Transfer Certificate of Title Nos. ___________________________________ and
situated at Brgy. Vira, Laoag City.
4. I am executing this affidavit to attest to the truth of the foregoing facts for all legal
intents and purposes.
IN WITNESS WHEREOF, I have hereunto set my hands this 10 th day of December,
2015 at Laoag City, Ilocos Norte.
JENYFLOR GLORIA H. SANTOS
Affiant
VIN 2812-0038A-B2384JHS2001-0
SUBSCRIBED AND SWORN to before me this 10 th day of December 2015 at Laoag
City, Philippines, affiant exhibited to me her Voters ID issued by COMELEC Laoag.

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