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Republic of the Philippines )

Province of Isabela )SS.


Municipality of Ramon )
x-------------------------------------x

AFFIDAVIT OF WAIVER OF RIGHTS

I, MERCEDES M. VIZCARRA, of legal age, Filipino, and a resident of Brgy. Bugallon Norte, Ramon,
Isabela after having duly sworn to in accordance with law depose and state that;

1. I am the same person after the same person executing this affidavit;

2. I am an applicant for Socialized Industrial Forest management Agreement in relation to that parcel of
land situated at Brgy. Gen. Aguinaldo, Ramon, Isabela, more particularly described as follows:

A parcel of land located at Gen. Aguinaldo, Ramon, Isabela; bounded on the N. by


Forest Zone; on the East by Forest Zone; on the S by Forest Zone; and on the W. by
Forest Zone, containing an area of SIX THOUSAND FOUR HUNDRED FORTY
SIX (6,446) SQUARE METERS, more or less,

Attached hereto is a copy of my Application with No. 02-0008-0079 marked as


Annex A hereof;

3. However, after the execution of the Agreement in relation to my application in the afore-mentioned
parcel of land I was not able to occupy and develop the same because I am busy with business.
Instead, it was MARY JEAN G. PIEDAD who occupied and developed the aforementioned parcel of
land;

4. Consequently, I hereby waive all my rights and interests as applicant over the said parcel of land in
favor to MARY JEAN G. PIEDAD, of legal age, Filipino, and a resident of Brgy. Gen. Aguinaldo,
Ramon, Isabela, her heirs, assigns and successors-in-interest over the said parcel of land;

5. As a result of this waiver of right, I herein voluntarily and peacefully surrender my application on the
said parcel of land in favor of MARY JEAN G. PIEDAD, her heirs, assigns and successors-in-interest
in the above-described parcel of land;

6. I am executing this affidavit willingly and voluntarily and to attest to the veracity of the foregoing.

IN WITNESS WHEREOF, I hereunto set my hands this 29th day of July 2015 at Ramon, Isabela,
Philippines.

MERCEDES M. VIZCARRA
Affiant
Drivers License No. D06-01-030445
Issued by LTO

SIGNED IN THE PRESENCE OF:

_______________________________ _______________________________

SUBSCRIBED AND SWORN to before me this 29th day of July 2015 at Ramon, Isabela, Philippines. I
hereby certify that the affiant personally appeared before me exhibiting her valid identification card as competent
proof of identity and signed this document before me.

WITNESS MY HAND AND SEAL


Doc. No. ________;
Page No. ________;
Book No. _______;
Series of ________;