REPUBLIC OF THE PHILIPPINES

PROVINCE OF PANGASINAN
MUNICIPALITY OF SAN FABIAN

AFFIDAVIT OF POSSESSION AND OWNERSHIP

I, DON DON I. IBASAN of legal age, Filipino Citizen, and resident of Brgy. Nibaliw Vidal, San
Fabian, Pangasinan, after having been duly sworn to in accordance with the law, do hereby depose
and say:

1. That we are the lawful and absolute owner of that parcel of land, situated in Brgy. Nibaliw
Vidal, San Fabian, containing an area of 1052 sq., m., more or less, and more particularly
bounded as follows.

A parcel of land situated in Brgy. Nibaliw Vidal, San Fabian, containing an area of 1052 sq.,
m., more or less. Bounded on the NE-SALVAGE ZONE (30-40 mw), SE-RIVER, Public land, NW & SW –
NILO L. DOJILLO, containing an area of 1052 square meters said parcel of Agricultural land and is
neither declared for taxation purposes in the Municipality of San Fabian, Pangasinan, neither
registered under Act 496, but register able under Act 334, as mended;

2. That we acquired this parcel of land, by way of actual possession and peaceful possession
and ownership, without any adverse interruption since 1980 to the present, and have been
enjoying and appropriating the fruits and the premises/or the same for our own family use
and benefit;

3. that we have executed this affidavit to attest the truth surrounding facts, for all legal
intents and purposes, and in compliance with the requirements in declaring the same for
taxation purposes, after due evaluation and consideration, and ask other relief’s or remedies
which are just, paper, wise and equitable under the premises.

Affianths further sayeth noneth.

IN WITNESS WHEREOF, we have hereunto signed our names below this ________ day of
___________, 2020, at San Fabian, Pangasinan.

DON DON I. IBASAN

Affidavit
ID no. ______________
Issued on:____________
Issued at:_____________

SUBSCRIBED AND SWORN to before me this ______ day of ________, 2020 at San Fabian
Pangasinan.