Republic of the Philippines )

Province of Bohol ) S.S.

___________________ )

AFFIDAVIT OF NO OTHER DONATION IN THE YEAR 2020

We, FELIPA S. ANTIAMPO, MESAEL S. ANTIAMPO, NENITA A. MANLULUYO, MARINA A. ZITO,

LEONORA A. BARBAS, CLEOFE A. GUMANID, NELSON S. ANTIAMPO, DEXTER S. ANTIAMPO, and
ARLENE A. TETANGCO, all Filipinos, of legal age, and residents of Poblacion, Catigbian, Bohol, under oath,
do hereby depose and say that:

1. We are the heirs of FAUSTINO ANTIAMPO, the true and lawful owner of Lot No. 30, PCS-07-
001024 (OLT) and all improvements thereon, situated at Barangay Poblacion, Catigbian, Bohol,
and more particularly described in Transfer Certificate of Title No. 904 containing a total
area of TWELVE THOUSAND THREE (12,003) SQUARE METERS, more or less;

2. We have executed a Deed of Extrajudicial Settlement with Simultaneous Donation of a portion of

the above-described parcel of land containing an area of ONE HUNDRED EIGHTY (180) Square
Meters, with all of the improvements found thereon in favor of BARANGAY POBLACION,
CATIGBIAN, BOHOL;

3. That we have made no other DONATION of real property within the year 2020;

4. That we have executed this Affidavit to attest to the truth of the foregoing facts and for whatever
legal purpose this may serve.

IN WITNESS WHEREOF, we have hereunto signed this instrument this ______________ at

________________________, Philippines.

FELIPA S. ANTIAMPO MESAEL S. ANTIAMPO NENITA A. MANLULUYO

Affiant Affiant Affiant
____________________ ____________________ ____________________
____________________ ____________________ ____________________

MARINA A. ZITO LEONORA A. BARBAS CLEOFE A. GUMANID

Affiant Affiant Affiant
____________________ ____________________ ____________________
____________________ ____________________ ____________________

NELSON S. ANTIAMPO DEXTER S. ANTIAMPO ARLENE A. TETANGCO

Affiant Affiant Affiant
____________________ ____________________ ____________________
____________________ ____________________ ____________________

Signed in the presence of:

___________________________ ______________________________

SUBSCRIBED and SWORN to before me on the date and place above-written.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 20__.