Adverse Claim for Deed of Conditional Sale) Republic of the Philippines) Province of ____________________)S.S.

City/Municipality of _____________) x---------------x AFFIDAVIT OF ADVERSE CLAIM I,_____________, of legal age, Filipino, (single / married / widow), and a resident of _____________, Philippines, after having been sworn to in accordance with law depose and say: 1.On _____________, I have entered into a Deed of Conditional Sale which was acknowledged on the same date before Notary Public _____________ of _____________ and entered in his Notarial Register as Doc. No. ______; Page No. ______; Book No. ______, Series of ______.A copy of the said Deed is hereto attached and made an integral part of this Affidavit; 2.That in the said Deed of Conditional Sale, I was the VENDEE of a certain parcel of land covered by Transfer Certificate of Title No. _____________, more particularly described as follows: Technical Description of Property) 3.That, because I still have a balance on the purchase price in the amount of P_____________ which is payable within _____________ (______) (year/months) from the date of signing thereof, it was stipulated in the aforementioned Deed that title and ownership over the subject property will only be transferred upon full payment of the same; 4.That the VENDOR in the said Deed of Conditional Sale agreed that upon its execution, said Deed shall be annotated in the Title with the Office of the Register of Deeds of _____________; 5. However, since the said Deed of Conditional Sale per se could not be annotated on the Title with the Office of the Register of Deeds, I am therefore executing this Affidavit for the purpose of attesting to the truthfulness of the foregoing allegations and in support of my request for the annotation of an adverse claim over the parcel of land covered by the Transfer Certificate of Title No. _____________. IN WITNESS WHEREOF, I have hereunto set my hand this _____________ in the City/Municipality of _____________, Philippines. Affiant (JURAT)