REPUBLIC OF THE PHILIPPINES)

_____________________________)S.S

AFFIDAVIT OF TRANSFEREE
I, JEANIELOU S. SMITH, of legal age, Filipino, married to Ryan N. Smith, a Canadian
and a resident of Brgy. Seguinon, Albuera, Leyte, Philippines, after having been duly sworn,
depose and say, THAT;
I am the vendee of that certain unsegregated portion of SIX HUNDRED (600) SQUARE
METERS parcel of land more particularly described as follows:
"A parcel of land, Lot 1413 C-2 Cad. 655, situated in Barangay Seguinon,
Municipality of Albuera, Province of Leyte, Island of Leyte. Bounded on the E-SE along
lines 1 to 10 by Lot 1416 C-2 Cad. 655; on the SW., along lines 10-11-12 by Lot 1411 C-
2 Cad. 655; on the NW., along lines 12-13-14 by Lot 1414 C-2 Cad. 655; and on the N.,
along lines 14-15-1 by Lot 1415 C-2 Cad. 655. Containing an area of TWENTY FOUR
THOUSAND FOUR HUNDRED EIGHTY (24,480) SQ. METERS, more or less,
covered under Original Certificate of Title No. P-96357 in the Office of the Registry of
Deeds for the Province of Leyte."
The said portion of land was acquired from FRANK EUGENIO CRUZ and ELVIRA G.
CRUZ, both of legal age, Filipinos, spouses and both residents of Brgy. Seguinon, Albuera,
Philippines, as evidenced by a Deed of Absolute Sale of Portion of land dated ____________,
2019;
The said portion of land subject to this sale is not tenanted, hence, the same is not covered
by Operation Land Transfer (OLT) nor by CARP,
My total landholdings inclusive of the land subject of the above-mentioned portion of land
subject to this sale does not exceed five (5) hectares throughout the Philippines;
I have furnished copy of this affidavit to the BARC as required;
I execute this affidavit in compliance with the DAR Administrative Order No. 1; Series of
1989, as well to show proof that we have an aggregate landholding not to exceed five (5) hectares
throughout the Philippines;
IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of
____________, 2019 at ____________________________.

JEANIELOU S. SMITH
Affiant
SUBSCRIBED AND SWORN TO before me this ____ day of ____________, 2019 at
___________________.

Doc. No. _____;

Page No._____;
Book No._____;
Series of 2019.