REPUBLIC OF THE PHILIPPINES

Province of __________________)S.S.
City of _______________)

AFFIDAVIT

I, _______________________, of legal age, single/married, Filipino, with

residence at _________________________________________________ after
having been duly sworn to in accordance with law, do hereby depose and state the
following:

1. That I am the registered owner of a parcel of Land situated in

____________________________, and the authorized representative to
process the correction of the technical description of a parcel of land
registered under my name;

2. That the aforementioned parcel of land is registered with the

______________________________ embraced and covered under
Transfer Certificate of Title No. _________________;

3. That Transfer Certificate of Title No. __________________ bears the

following description:

“Technical Description”

4. THAT THE FOLLOWING ENTRIES AS APPEARING ON THE ABOVE-

MENTIONED TECHNICAL DESCRIPTION WERE ERRONEOUSLY ENCODED
AS:

i.

ii.

5. That Transfer Certificate of Title No. _______________ after correcting the

above-mentioned erroneous entries should read as:

“Correct Technical Description”

6. That I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purposes that this statement may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this ____ day of

____________, in the City of __________, Philippines.

_______________________
AFFIANT

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for the City
of ____________, this _____ day of ____________ _____. Affiant personally came
and appeared with his/her _________________ bearing his/her 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.

Doc No. ______;

Page No. ______;
Book No. ______;
Series of 20____.