REPUBLIC OF THE PHILIPPINES)

CITY/PROVINCE OF ILOILO ) S.S.

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AFFIDAVIT OF VOLUNTARY SURRENDER

That I, FLORENTINA S. CLAVEL, of legal age, widow and, Filipino and a

resident of Brgy. San Miguel, Iloilo, Philippines, under-oath depose and say:

1. That I and my husband, PATRICIO J. CLAVEL, the actual

cultivators/tillers/agricultural tenants of a certain landholdings, known and
identified now as Lot No. 25 of the Cadastal Survey of San Miguel situated in
the Municipaliy of San Miguel, Iloilo and covered by Transfer Certificate of
Title No. T-79428;

2. That my husband Patricio J. Clavel died in 2010 and due to my old age and
failing health, I am no longer interested to till or cultivate the said
landholdings, and for this reason, we voluntarily decided to turn- over or
surrender the landholdings to the registered owner Virginia G. Espino, of legal
age, married, Filipino and a resident of Brgy. Taclobo, Dumaguete City

3. Henceforth, I respectfully ask the Department of Agrarian Reform to delete and

cancel our name in the DAR’s Master List of Tenants.

4. That I fully understood all the contents of this affidavit;

That Iexecute this affidavit in good faith and attest the truth of all narrated facts,
for whatever legal purpose it may duly serve.

IN WITNESS WHEREOF, I have hereunto set our hands this 21st of January, 2019
at Iloilo City, Philippines.

FLORENTINA S. CLAVEL
OSCA ID NO. 16463

SIGNED IN THE PRESENCE OF:

__________________________ & __________________________

SUBSCRIBED AND SWORN to before me this 21st of January, 2019 at Iloilo City,
at Iloilo City, Philippines. The affiant whose name and personal circumstances are stated
above appeared in person before me and presented the foregoing document, signed the
same in my presence, and affirmed or swore, under-oath to the correctness of the
contents of the allegations thereof.