REPUBLIC OF THE PHILIPPINES)

CITY OF CALAMBA )S.S.

AFFIDAVIT OF NON-TENANCY

I, ________________, married to ____________, both of legal age, both Filipino

Citizen, and residents o fBrgy. Mayapa, Calamba City, Laguna, after having been
sworn according to law, depose and say:

1. That I am the registered owner of a parcel of land situated in Brgy. Majada,

Calamba City, Laguna, with an area of One Thousand Three Hundred Nine
(1,309) square meters, covered by and more particularly described in Transfer
Certificate of Title No. __________ of the Registry of Deeds for Laguna,
Calamba Branch, copy of the Title is attached as Annex “A” and made part
hereof;

2. That the above-mentioned parcel of land, classified as follows:

a.) Dryland/Agricultural - 1,000.00 sq. ms.
b.) Residential - 309.00 sq. ms.

3. That the said One Thousand (1,000) square meters though classified as
Dryland/Agricultural is not planted to any crop and has no tenant and no
pending cases in any court or government agency concerned;

4. That this Affidavit is executed to attest the truth of the foregoing facts in
particular that the above-described property is not tenanted and not planted
with any crop.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of

_______________________ at Calamba City.

________________
Affiant

SUBCRIBED AND SWORN to before me this _____ day of

_______________________at Calamba City, affiant exhibiting to me her _______ ID
No. ________________ issued by _____________________ on _______________ at
_______________.

Doc. No. _______; Notary Public

Page No. _______;
Book No. _______;
Series of 2021.