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 ispayable 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.