Republic of the Philippines)

City of Cabanatuan . . . . . . )S.S.

X----------------X

AFFIDAVIT OF ADVERSE CLAIM

I, FERNANDO B. RIVERA, of legal age and with postal address at Brgy. Rajal
Sur, Santa Rosa, Nueva Ecija, after having been duly sworn to in accordance with law
hereby depose and states the following:

1. That parcel of land is registered in the Registry of Deeds of Cabanatuan City

registered in the name of JOCELYN PABLO, of legal age, single and a
resident of Brgy. Rajal Sur, Santa Rosa, Nueva Ecija and said parcel of land is
more particularly described as follows;

TRANSFER CERTIFICATE OF TITLE

NO. 041-2014003698

“A parcel of land (Lot 51 of the cons.-subd. plan Psd-03-012394

OLT x x x Containing an area of FOUR HUNDRED SEVENTY
SEVEN (477) SQUARE METERS, more or less.”

2. That I have an adverse claim in that parcel of land above mentioned as I am

the owner of the same which is registered under TRANSFER CERTIFICATE
OF TITLE NO. EP-36550, a copy of which is hereto attached as ANNEX
“A”;

3. That for several years I temporarily reside in Palawan due to my work and I
was not aware nor consented to the said transfer;

4. That my adverse claim consists of my ownership over the said parcel of land
as I NEVER consented to any sale and/or transfer of the said property and I
NEVER abandoned the said property;

5. That I am executing this affidavit to attest to the truth, correctness and

veracity of the herein disclosed facts and to request the Register of Deeds of
Nueva Ecija to REGISTER/ANNOTATE this Adverse Claim on the title in the
manner provided by law.

IN WITNESS HEREOF, I have hereunto set my hand this ____day of August

2018 hereat Cabanatuan City.

FERNANDO B. RIVERA
Grantor
ID No. 011-83-016282
Issued by: LTO

SUBSCRIBED AND SWORN TO before me this ___ day of August 2018 hereat
Cabanatuan City, affiant personally appeared exhibiting to me his valid proof of
identification, details of which are written above.