REPUBLIC OF THE PHILIPPINES)
MUNICPALITY OF BALINGASAG) S.S.
x-------------------------------------x
SWORN AFFIDAVIT
I, PETER BACUS of legal age, Filipino, and a resident of Balingasag, Misamis Oriental,
after having been duly sworn to in accordance with law, depose and state:
1. That I am the Manager of GRAVELDEN INC. with office address at Balingasag,
Misamis Oriental ;
2. That my company has been granted sand and gravel permit by the MGB-DENR at
Balingasag, Misamis Oriental;
3. That on March 07, 2020 AH Trucker Construction Aggregates and Trading represented
by its Drivers had bought two (2) truckloads of sands onto Dump trucks with LTO CR
Nos. 36223209-1 and 362223207-6; with Plate Nos. NEG1948 and NEG2065;
4. That I affirm and declare that Dump trucks with LTO CR Nos. 36223209-1 and
362223207-6; with Plate Nos. NEG1948 and NEG2065 with its Drivers had bought sand
and gravel at Gravelden Inc.;
5. That I am executing this affidavit to attest the truth of the foregoing facts and for
whatever purpose this may serve.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I hereby affixed my signature this ____, in
_______, 2020, Balingasag, Misamis Oriental, Philippines.
PETER BACUS
Affiant
. Driver’s License No.
Expires on:
Issued at
SUBCRIBED AND SWORN TO before me this ____ in _________, 2020,
Municipality of Balingasag, Philippines, affiants exhibiting to me his/her competent
evidence of identity by way of Driver’s License.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2020.