REPUBLIC OF THE PHILIPPINES ]

AFFIDAVIT OF CANCELLATION
OF PROTEST/ADVERSE CLAIM

I, ______________, of legal age, married, Filipino citizen and resident of

Brgy. _________________, after having been duly sworn to in accordance with
law, do hereby declare and manifest:

That per cadastral record of DENR, Lot No. _____ consisting of ____
square meters and located in Brgy. __________ is surveyed in the name of
__________ and there was an annotation therein that the subject lot is included
in the letter dated _________ of my deceased father, __________;

That I am the sole and surviving heir of __________ who died many years
ago;

In view thereof, I hereby CANCEL whatever letter protest, adverse claim

or any interests which my deceased father had executed over the subject lot in
favor of the present owner, _______________.

That I am executing this affidavit in order to attest the truth of the

foregoing and in order to request the Department of Environment and Natural
Resources (DENR), to cancel the aforesaid letter protest/adverse claim dated
____________ as annotated in the cadastral record and in order for the rightful
owner to apply for her respective title over the subject lot.

IN WITNESS WHEREOF, we hereunto signed this Affidavit this ____ day

of _________________ at ___________ Philippines.

____________________
Affiant
ID No. _________________

Signed in the Presence of: __________________ ___________________

SUBSCRIBED AND SWORN TO before me this ____ day of __________________ at

_____________. Affiant personally appeared and her identity was personally confirmed
and she exhibited to me her Valid Identification Card indicated below her name.