REPUBLIC OF THE PHILIPPINES)

CITY OF TAGBILARAN) S.S.

AFFIDAVIT OF DECLARATION OF NON-OWNERSHIP

I, ___________________,of legal age, Filipino citizen, _______, and residing at

__________________, Bohol, after having been duly sworn to in accordance with law,
do hereby depose and say, that:

1. I am in posssession of a certain parcel of land situated in Barangay

____, Municipality of ______, Province of Bohol, and more
particularly bounded and described as follows:

Title No. _____

(Technical Description)

2. The above described parcel of land is owned and registered in the

name of __________;

3. I am a mere holder of the said parcel of land by mere tolerance of the

lawful and registered owner _________;

4. I have no ownership claim in the saidreal property and that my

possession cannot ripen into ordinary nor extraordinary acquisitive
prescription;

5. I never had an ownership interest in the said property and that my

heirs, assigns and successors in interest therein cannot acquire
successionalrights to the same; and

6. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever other legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ______________, at

Tagbilaran City, Bohol, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN to before me this ________________________, at

Tagbilaran City, Bohol, Philippines, affiant exhibiting to me his/her competent evidence
of identity: ___________________________________

Notary Public

Doc. No. ___;

Page No. ___;
Book No.___;
Series of 2019.
REPUBLIC OF THE PHILIPPINES)
CITY OF TAGBILARAN) S.S

SUMPAHAYAG SA DEKLARASYON SA WALA PAGPANAG-IYA

Ako si, _______________, Pilipino, sa legal nga panuigon, ug lumulupyo sa

__________________, human mihural subay sa balaod, manumpa ug muingon, nga:

1. Ako naga hawid sa usa ka luna sa yuta nga nahimutang sa _______, ug

kini partikularmenteng gihugpong ug gihulagway sa musunod:

Title No. ____

(Technical nga Paghulagway)
2. Ang gihulagway nga luna sa yuta sa ibabaw kay gipanag-iya ug
rehistrado sa ngalan ni ________;

3. Ako isip lamang tighawid sa maong luna sa yuta pina-agi lamang sa

pagtugot sa tinuod ug rehistradong tag-iya nga si ___________;

4. Akowala magtinguhangapanagiyahonangmaongyutaugngaang akong

paghawid niini dili muhinkod sa ordinaryo ni ekstraordinaryo nga preskripsyon
nga pag-angkon sa yuta;

5. Ako wala sukad manag-iya sa maong luna

sayutamaongaangakongmgaeredero, asayin, ugmanununoddili gayudmaka-
angkonogkatungodsapagsunodsamaong luna sa yuta;

6. Ako nagabuhat niining sumpahayag para pamatud-an ang kamaturoan sa mga

gibuhiang pamahayag ug para sa lain pang balaodnong katuyuan nga makasilbi niini.

SA PAGSAKSI NIINI, Ako diri milagda sa akong kamot karong ___________,

sa
Tagbilaran City, Bohol, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN to before me this ________________________, at

Tagbilaran City, Bohol, Philippines, affiant exhibiting to me his/her competent evidence
of identity: ___________________________________

Notary Public

Doc. No. ___;

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