REPUBLIC OF THE PHILIPPINES]

TRANSFEROR’S AFFIDAVIT

I, ____________, of legal age, Filipino citizen, single, and with post

office address at ____________, after having been duly sworn to in
accordance with law, hereby depose and state:

That I am the transferor of that parcel of land, more particularly,

Lot No. _____________containing an area of __ square meters and located
in Brgy. __________ by virtue of Deed of Absolute Sale executed and
entered in the Notarial Register of Atty. _____________________ as Doc. No.
____; Page No. _____; Book No. ____; Series of 2020;
That the aforesaid parcel of land formerly formed part of the
retention area of five (5) hectares and the same is not tenanted and is
therefore not covered by P.D. No. 27 nor the Comprehensive Agrarian
Reform Law;

That I am executing this affidavit in compliance with the provisions

of Department of Agrarian Reform Administrative Circular No. 1, Series
of 1989.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

___ day of _______________ at _____________, Philippines.

_____________________
Affiant
ID No. _______________

SUBSCRIBED AND SWORN TO before me this ___ day of

____________ at _______________. Affiant/Transferor personally appeared
and his identity confirmed with his Valid Identification Card indicated
above and declare that he fully understood the contents of this affidavit
and that it is executed freely and voluntarily.

Doc. No.: ______;

Page No.: ______;
Book No.: ______;
Series of 2020.