TO : THE REGISTRY OF DEEDS

Butuan City

REQUEST
FOR PARTIAL WITHDRAWAL OF
ADVERSE CLAIM

I, FELISA DARAGOSA KIONISALA, of legal age, widow and a resident of P-2, Lilo,
Banza, Butuan City, UNDER OATH, hereby depose and state –

That I on November 19, 2019, I executed an Adverse claim on that property

embraced by KOT blg. P-3408, situated in Banza, Butuan City, notarized by Atty. Joseph E.
Tomaneng and entered in his notarial registry as Doc. 324, Page 65, Book 134 series of
2019;

That my adverse claim of ownership only extends to the interest of my late husband,
Raul D. Kionisala, in said property and does not extend to the portions thereof which have
been conveyed to his siblings, as their share in the property, more particularly, to:

A. ERLINDA KIONISALA TAMOLING – Lot F, Psd-13-008200 with an area of 225 sq.

meters.
B. REMEDIOS KIONISALA CHING - Lot C, Psd-13-008200 with an area of 225 sq.
meters.
C. BEATRIZ KIONISALA ISRAEL - Lot E, Psd-13-008200 with an area of 225 sq. meters.
D. BARTOLOME D. KIONISALA - Lot B, Psd-13-008200 with an area of 225 sq. meters.
E. VIRGINIA FE K. PLAZA - Lot D, Psd-13-008200 with an area of 225 sq. meters.
F. LYDIA K. CADAOAS -Lot A, Psd-13-008200 with an area of 250 sq. meters.
G. LUZ K. AYAG – 300 sq. meter (as annotated in KOT blg. P-3408)

I therefore withdraw my adverse claim of ownership over the following portions of the
land embraced by KOT blg. P-3408, to wit:

A. ERLINDA KIONISALA TAMOLING – Lot F, Psd-13-008200 with an area of 225 sq.

meters.
B. REMEDIOS KIONISALA CHING - Lot C, Psd-13-008200 with an area of 225 sq.
meters.
C. BEATRIZ KIONISALA ISRAEL - Lot E, Psd-13-008200 with an area of 225 sq. meters.
D. BARTOLOME D. KIONISALA - Lot B, Psd-13-008200 with an area of 225 sq. meters.
E. VIRGINIA FE K. PLAZA - Lot D, Psd-13-008200 with an area of 225 sq. meters.
F. LYDIA K. CADAOAS -Lot A, Psd-13-008200 with an area of 250 sq. meters.
G. LUZ K. AYAG – 300 sq. meter (as annotated in KOT blg. P-3408)

I categorically state herein that my adverse claim of ownership over the remaining
portion of the land embraced by KOT blg. P-3408, corresponding to the interest of my late
husband, Raul D. Kionisala, in the said property, stays.

I respectfully request the Registry of Deeds of Agusan del Norte to register the
foregoing partial withdrawal of adverse claim.

I execute this Affidavit to attest to the truth of the foregoing.

IN WITNESS WHEREOF, I hereunto affix my signature this ______________________________ at

Butuan City, Philippines.
 FELISA DARAGOSA KIONISALA
ID No. ________________________

SUBSCRIBED AND SWORN TO BEFORE ME, this ____________________________________ at

Butuan City, Philippines.