REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) Sc.

MUNICIPALITY OF TUBAO )
x-------------------------x

PETITION TO CANCEL ADVERSE CLAIM

I, PABLO PASCUA, of legal age, Filipino citizen, married and with residence and post
office address at Gonzales, Tubao, La Union, after having been duly sworn to an oath in
accordance with law.

That I am the registered owner of the real property located at Gonzales, Tubao, La
Unionand covered by Tax Declaration No. 2009-19-0008-00560;

That under date of April 19, 2005, there was registered at the instance of Florentino
Pascua a notice of adverse claim on the aforementioned Tax Declaration;

That more than thirty (30) days having elapsed from and after the date of its registration,
said notice of adverse claim already has lost its force and effect and may now be cancelled
pursuant to the provision of Sec. 70 of P.D. 1529.

WHEREFORE, the herein petitioner respectfully petitions the Register of Deeds of La

Union and Office of the Provincial Assessor of La Union to effect the cancellation of
aforementioned adverse claim annotated on Declaration No. 2009-19-0008-00560.

IN WITNESS WHEREOF, I have hereunto set my hand this 28th day of April 2014 at
Tubao, La Union, Philippines.

PABLO PASCUA
Affiant
ID ____________________

SUBSCRIBED AND SWORN to before me this 28th day of April 2014 at Tubao, La
Union by the affiant appearing personally and who is known to me to be the same person who
executed this affidavit.

ATTY. JOONEE RANDYL E. RIVERA

Notary Public
Doc. No.: 457; until December 31, 2014
Page No.: 92; Aspiras Highway, Francia Sur, Tubao, La Union
Book No.: II; Roll No. 61766, TIN 929-347-628
Series of 2014. PTR No. 8538617; 01-02-14, Tubao, LU
IBP Lifetime OR No. 933274; 01-02-14, SFLU