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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 Washington Street, 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 NotarialRegister 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 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. 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 Makati City;

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 in Makati 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.

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