REPUBLIC OF THE PHILIPPINES

PROVINCE OF CAGAYAN
CITY OF TUGUEGARAO

AFFIDAVIT OF SPLITTING

That I, __________________, of legal age, married, Filipino and a resident of

______________________________ after duly sworn to in accordance to law do
hereby depose and state:

That I am the lawful owner of a certain parcel of land located at

_________________ identified as ________________, with an area of
______________________square meters covered by TCT No.
______________________.

That I have deicided to split the remaining area of the mentioned parcel
of land into _____ lots designated as Lot 7, 8, 9, 10, 11, 12, 13, and 14 with a
total area of ONETHOUSAND TWENTY FOUR (1,024) square meters.

That I am executing this affidavit freely and voluntarily without force,

threat or intimidation to attest the truth of the foregoing facts.

________________________
Affiant

SUBSCRIBED AND SWORN to before me this __________________, at

Tuguegarao City, Cagayan.

Doc No. ____

Page No. ____
Book No. ____
Series of 2019.