Republic of the Philippines )

Province of Davao del Norte ) S. S.

City of Tagum )
x----------------------------------x

AFFIDAVIT OF VENDOR’S NON-TENANCY AND LANDHOLDING

I, ______________________________________________, of legal age,

Filipino, single/married/widow/widower/ and a resident
___________________________________________________________________, Philippines,
after having been duly sworn to in accordance with law do hereby depose and say that:

1. I am the same person affiant in this affidavit, likewise I am the registered owner of a certain
parcel of land situated at Barangay
____________________________________________________________________,
consisting an area of _________________________________________________________
(________) Square Meters, more or less, identified as Lot No.
_____________________________________________ covered and embraced under
Original/Transfer Certificate of Title No. ________________________________;

2. However, the aforesaid parcel of land was the subject of a Deed of Absolute Sale which I
have executed in favor of ________________________________ per Doc.
No.______________; Page No. ______________; Book No. _______________; Series of
__________, dated _________________________ and entered under the Notarial Registry
of Atty ______________________________________________________, for his Notarial
Commission in the Province of ___________________________________________
Philippines;

3. The aforesaid land is not tenanted nor worked by any agricultural lessee or in any form of
share crop and/or leasehold tenancy, hence, it is not within the purview of P.D. 27 and its
implementing rules and regulations;

4. My total aggregate landholdings including the aforesaid parcel of land subject of the said
Deed of Absolute Sale does not exceed five (5) hectares;

5. That I am executing this affidavit to informed the concerned authorities and for whatever
legal purpose this may well serve.

IN WITNESS WHEREOF, I have hereunto set my hand this______________, at

Ta gum City, Davao del Norte, Philippines.

______________________________
Affiant
Valid ID No. ________________________
Issued on /Valid until _________________
Issued at ___________________________

SUBSCRIBED AND SWORN to before me this____________________ at

Tagum City, Davao del Norte, Philippines.

Doc No. ___________;

Page No.___________;
Book No.___________;
Series of ___________.

_____________________________
BARCH Chairman
Barangay _____________________