REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF ___________ ) S.S.
x-------------------------------------x
AFFIDAVIT OF ADVERSE CLAIM

       I, LOURDES BATANG, of legal age, Filipino and a resident of Solana,

Cagayan, after having been duly sworn to in accordance with law, depose and
state:

1. That on September 17, 1991, I have entered into an absolute sale of a portion
of land with Danilo Capalungan, the sole heir of Jacob B. Capalungan which
was acknowledged on the same date before Notary Public Atty. MacPaul
Soriano and entered in his Notarial Register. A copy of the said Affidavit of
Extra-Judicial Settlement with Sale is hereto attached as ANNEX
“A” and made an integral part of this Affidavit;

2.  That in the said affidavit, I was the VENDEE of a portion of the aforesaid
parcel of land consisting of 8, 888 square meters covered by
Original Certificate of Title No. V40196, more particularly described as
follows:

“Lot No. 2325, Cad-293 with an area of 40,255 square meters, located at
Andarayan, Solama, Cagayan.”

4. That I wanted to protect my rights over the said portion of property and to
give warning to third persons that the same has already sold in my favor;

5. However, since the said Affidavit of Extra-Judicial Settlement with Sale

per se could not be annotated on the Title with
the Office of the Register of Deeds of Tuguegarao City, Cagayan, I am
therefore executing this Affidavit for the purpose of attesting to the
truthfulness of the foregoing allegations and in support of my request for
the annotation of an adverse claim over the parcel of land covered by the
Original Certificate of Title No. V40196.

IN WITNESS HEREOF, I have hereunto set my hand, this______ day

of _____________, 2018 in ______________________.
          

LOURDES BATANG
Affiant

Witnessed by: ________________________

Barangay Official

    SUBCRIBED AND SWORN TO before me, this ______ day

of _____________, 2018 in ______________________. Affiant exhibiting to me
her ___________ identifcation card bearing number __________ as proof of
identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2018.