AFFIDAVIT OF THIRD PARTY CLAIMANT

I, ___________________________, of legal age,

single/married, and a resident of
_______________________________________________________
_, being first sworn to in accordance with law, depose and state:

That I am the true, lawful and absolute owner of that certain

property, now in the possession of ___________________, and
presently being levied upon and more particularly described as
follows:

_______________________________________________________
___________

_______________________________________________________
___________ ________________________(description of
property)______________________

_______________________________________________________
___________

_______________________________________________________
___________

_______________________________________________________
___________

That the value of the above described property is Php

_______________;

That I hereby claim said property as my own, being entitled to

its ownership and possession.

Baguio City, _____________________, 20___.

________________
Signature of Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for
_________(City/Province)____________ this ____th day of ____________
20___. Affiant personally came and appeared with _____________(Competent
Evidence of Identity)______ issued by the _________(Government
Agency)______ on ___(date)__ at ________(place)_________, bearing his
photograph and signature, known to me as the same person who personally
signed the foregoing instrument before me and avowed under penalty of law to
the whole truth of the contents of said instrument.

Atty _______________________________________
Notary Public
Doc. No. ____ Commission Serial No. __________________
Page No. ____ Notary Public for _______(Province/City)_____
Book No. ____ Until December 31, 20__
Series of 20__ Office: ____________(address)____________
Roll No. __________
IBP Lifetime Roll No. ________; __/__/__ ; (Province)
PTR No. _________ ; __/__/__ ; _(Province)_
MCLE Compliance Cert. No. __________; __/__/__

[12CD]