(Affidavit for Cancellation of Entries in TCT)

Republic of the Philippines)

Province of ____________________)S.S.
City/Municipality of _____________)
x------------x

AFFIDAVIT

I, _____________, of legal age, Filipino, (single / married / widow), and a resident of

_____________, Philippines, after having been duly sworn to in accordance with law, hereby
depose and state, that:

1.That I am the true and registered owner of a certain parcel of land which is covered by
Transfer Certificate of Title No. _____________, more particularly described as follows:

(Technical Description of Property)

2.That annotated on said Transfer Certificate of Title No. _____________ are the following
entries, to wit:

3.That the effectivity and efficacy of said entries have since expired as shown by the
dates thereon and/or were correspondingly superseded by other entries which are also
being caused to be cancelled in view of the fact that the party to said annotation has
registered no opposition to its cancellation.

4.That I am executing this affidavit purposely requesting the Register of Deeds to cause
the cancellation of the above-mentioned entries in the aforementioned Transfer
Certificate of Title.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____________ at

_____________, Philippines.

Affiant

(JURAT)