Republic of the Philippines )

Province of Cavite ) S.S

City of Trece Martires )

AFFIDAVIT OF CANCELLATION

I, JOSELITO SAMSON GALAN, of legal age, married, Filipino citizen, and a resident
of 366 Panamitan, Kawit, Cavite, Philippines, after having sworn to in accordance with law,
hereby depose and state that:

1. That I am the legal heir of the deceased JUANITO TABING GALAN who died on
15 January 2021 at Kawit, Cavite, Philippines and CECILIA S. GALAN who died
on 16 March 2019 at Kawit, Cavite as a corroboration of this facts is hereto
attached the faithful machine reproduction of their Certificate of Death as an
integral part of this affidavit;

2. That the deceased JUANITO TABING GALAN and CECILIA S. GALAN are the
registered owners of a real property, situated at Pinagsanhan B, Maragondon,
Cavite with an area of Nine Thousand One Hundred Seventy Seven (9,177)
Square Meters described under Tax Declaration No. AA-13 0021 00876, Lot No.
1376-A;

3. That the above said real property has an application for Free Patent with Patent
RFPA (IV-4) 042113-611 dated October 19. 2017;

4. That I am executing this affidavit to attest of truthfulness of the foregoing facts

under penalties of perjury,

5. That I am further executing this affidavit to formally request at the office of

CENRO/PENRO to CANCEL the Free Patent Application of the above said real
property, and to give way for the new owner JOSE LUIS ABAD GALAN for the
new application for Free Patent, moreover to support all other legal intents;

IN WITNESS WHEREOF, I hereby affix my signature on this ___________________________

day of ___________________________ at Trece Martires City, Cavite.

JOSELITO SAMSON GALAN

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME on this ___________________________ day of

__________________________ the affiant exhibited to me his Voter’s Identification bearing the
number VIN:2111-0127A-B2063JSG10001-7 as competent proof of his identification, and
avowed to me the foregoing facts and declarations.

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