THIRD PARTY CLAIM

AF F I DAVI T

Republic of the Philippines)

City of Davao )S.S
x-------------------------------x

I, SUSANE L. CARREON of legal age, single, resident of 64 Garden Park Village,

Matina, Davao City, being first sworn in accordance with law, depose and say:

That I am the true, lawful, and absolute owner of a private vehicle, now in the possession
of JENNIFER VILLARUEL, and presently being levied upon and more particularly described
as follows, to wit:

Series: LACER
Plate No.: LBP 112
Make: FORD
Chasses No.: SUPJAE-04930
Engine No.: SUPJAE-04930
Color: BLUE
Type: SEDAN

That the value of the above-described property is Eighty Thousand Pesos (P80,000.00) ;

That I hereby claim said property as my own, being entitled to its ownership and
possession.

(Sgd) SUSANE L. CARREON

Affiant

SUBSCRIBED AND SWORN to before me, this August 28, 2009, in the City of Davao,
with affiant exhibiting his CTC No. 785432, issued on August 4, 2009 at Davao City.

(Sgd) ATTY. ALMIRA A. BAES

NOTARY PUBLIC
Until December 31, 2009
P.T.R. No. 765532
January 3, 2008

Doc. No. : 178

Page No. : 56
Book No. : 34
Series of 2009