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REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI
) S.S.
x-------------------------------------x

AFFIDAVIT OF ADVERSE CLAIM

I, MARIE B. DELA CRUZ, of legal age, Filipino, single and a resident of


2223 WashingtonStreet, Pio del Pilar, Makati City, after having been duly sworn to in
accordance with law, depose and state:
1. That on July 10, 2013, I have entered into a Deed of Conditional Sale which was
acknowledged on the same date before Notary Public Juan Tamad of Makati City and
entered in his Notarial Register as Doc. No. 2, Page 2, Book II, Series of 2013. A copy
of the said
Deed is hereto attached as ANNEX A and made
an integral part of thisAffidavit;
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. 111222, 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 P500,000.00
which is payable within one (1) (year) 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 MakatiCity;
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. 111222.

IN WITNESS WHEREOF, I have hereunto set my hand this 26th day


of September 2013 inMakati City, Metro Manila, Philippines.

MARIE B. DELA CRUZ


Affiant
SUBCRIBED AND SWORN TO before me this 26th day of September
2013 in Makati City, Metro Manila, Philippines, affiant exhibiting to me her Philippine
Passport No. 123456 issued in Manila on January 12, 2012 and valid until January 12,
2017.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2013.

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 aresident of
_____________, Philippines, after having been sworn to inaccordance with law depose
and say:1.On _____________, I have entered into a Deed of Conditional Sale
whichwas 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 saidDeed 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 certainparcel 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 theaforementioned Deed that title
and ownership over the subject property willonly be transferred upon full payment of the
same;4.That the VENDOR in the said Deed of Conditional Sale agreed that upon
itsexecution, said Deed shall be annotated in the Title with the Office of theRegister of
Deeds of _____________;5. However, since the said Deed of Conditional Sale per se
could not beannotated on the Title with the Office of the Register of Deeds, I am
thereforeexecuting this Affidavit for the purpose of attesting to the truthfulness of
theforegoing allegations and in support of my request for the annotation of anadverse

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