DAR CLEARANCE FORM 3.

Republic of the Philippines )

Municipality of _______________________) S.S.
Province of Bohol )

AFFIDAVIT OF TRANSFEREE

I, ARMIE LOU SOLOMON BATAYOLA, of legal age, Filipino, with residence at San
Diego, California, USA, after having sworn according to law, hereby depose and say:

1. That I own a total aggregate landholding of ____________ square

meters/hectares including the area of ____________ square meters/hectares,
more or less, that I am acquiring from
__________________________________________________, under Doc.
No. _____; Page No. ____; Book No. ______; Series of 20______; of Notary
Public Atty. ________________________________ dated _______________
; and,

2. That this affidavit is executed in compliance with DAR Administrative Order

No. 1, Series of 1989, as well as to show proof that my total aggregate
landholding inclusive of the land subject of the abovementioned transaction
does not exceed five (5) hectares.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______ day of October
2019 at ________________________.

ARMIE LOU SOLOMON BATAYOLA

Affiant
(Signature over printed name)

SUBSCRIBED AND SWORN to before me this ______ day of _________________

20____ at _________________________ affiant exhibited his/her ID/Community Tax Certificate
No. ______ issued at _________________________ on _________________________, 20____.

Doc. No. ______;

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