REPUBLIC OF THE PHILIPPINES)

PROVINCE OF DAVAO DEL SUR )S.S.

MUNICIPALITY OF BANSALAN)
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AFFIDAVIT

I, _____________, of legal age, Filipino, __________ and a

resident of __________________, Davao del Sur, Philippines, after having
been duly sworn to in accordance with law do hereby depose and say:
1. That I am the same and identical person who caused the
execution of this affidavit.

2. That I am currently the security keeper of the parcel of land

particularly described as follows;

“A parcel of land known as, _____________________”

3. That I am not a tenant nor have any right to the above-

mentioned property.

4. That I am executing this affidavit freely and voluntarily to attest

to the truth and veracity of the foregoing allegations.

IN WITNESS WHEREOF, we have hereunto set my hand this

__________ at Banslan, Davao del Sur Philippines.

Affiant

SUBSCRIBED AND SWORN TO BEFORE me this ___________ at

Bansalan Davao del Sur, affiant exhibited to me her valid identification no.
shown above below her name.