REPUBLIC OF THE PHILIPPINES }

PROVINCE OF }
MUNICIPALITY OF __________ } S.S.

AFFIDAVIT OF CONSOLIDATION OF OWNERSHIP-

PACTO DE RETRO SALE
I, ___________________, of legal age, Filipino, single and a resident
of________________________________, after having been duly sworn to in accordance
with law, depose and state:

1. That on January 01, 2020, ABCD EFGH, of legal age, Filipino, single, residing
at______________________, sold to me a certain parcel of land under pacto de retro,
executed before Notarial Public Atty. ZZZ YYY and bearing Not. Reg. No. 1, Page 2,
Book III, Series of 2021 of his Notarial Register (copy of the said pacto de retro sale is
hereto attached as ANNEX “A”);

2. That pursuant to the deed of sale with pacto de retro, the said vendor, ABCD EFGH,
should have exercised his right to repurchase the said property within the period of two
(2) years;

3. That the period expired on _________________ without the said vendor, by himself or
by any other person in his behalf complying with the condition and stipulation required
for the repurchase of the said property;

4. That the said period of repurchase has not been extended, either expressly or
impliedly, by affiant vendee a retro;

5. That by virtue of the said deed of sale with pacto de retro, and by the failure of the
vendor, ABCD EFGH, to duly repurchase the property within the period stipulated,
there was consolidated in the affiant, as vendee a retro, the absolute ownership of the
said property. Attached hereto, as ANNEX “B,” is an order of the Regional Trial Court
of _____________ issued on __________________, approving and confirming the
above consolidation of ownership in the name of affiant.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ____________
2021 in _____________________, Philippines.

_______________________________
XXXXXXXXXXXXXXXXXX
Affiant
ID No.
Issued on:
Place of Issue:

SUBSCRIBED AND SWORN to before me at_______________________,

Philippines this _____ day of ___________, 2021, affiant exhibiting before me her
Competent Evidence of Identity written below her name and signature, that she is the
same person who personally signed before me the foregoing Affidavit and
acknowledged that she executed the same.