Republic of the Philippines

Misamis Oriental . . . . . ) S. S.

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AFFIDAVIT OF TRANSFEROR/VENDOR

I, LEONIDES T. GAMOLO, of legal age, Filipino, a resident of #6 Beta St.,

Midtown Subd. San Roques, Marikina City, after having duly sworn to in accordance
with law, state and declare that:

1. I am a registered owner of a parcel of land known as Lot # 1741-C,

situated in the Barrio of Mandangoa, Mun. of Balingasag, Province of
Misamis Oriental, Island of Mindanao, consisting of an area of one
thousand nine hundred thirty-two (1,932) square meters.

2. I sold the abovementioned land to WENCESLAO T. GAMOLO, JR., of

legal age, married and a resident of Brgy. 6, Balingasag Misamis Oriental,
the said sale being embodied or covered by an instrument denominated
as a “DEED OF SALE OF A PARCEL OF LAND”, which document is
registered in the notarial register of Notary Public ATTY. LUIS M. DE
VERA, as Doc No. 255, Page No. 51, Book No. IX, Series of 2017.

3. I hereby declare that the portion of the above-mentioned parcel of land

known as Lot No. 1741-C is part of my retention area, and I hereby
declare that my total/aggregate agricultural landholdings in the
Philippines, including the said parcel of land, does not exceed five (5)
hectares.

4. That the above-mentioned parcel of land known as Lot No. 1741-C is not
tenanted.

5. That the said parcel of land has no pending civil or criminal case at the
Department of Agrarian Reform Adjudication Board (DARAB), or any of its
adjudicators, the department of Agrarian Reform (DAR), the courts or at
the Office of the President

6. This affidavit is executed in compliance with DAR Administrative Order No.

1, Series of 1989 and to show proof that my total/aggregate agricultural
landholdings in the Philippines, including the above-mentioned parcel of
land known as Lot No. 1741-C, does not exceed five (5) hectares.

7. I am executing this affidavit to establish all of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto affixed my signature this______day

of________________________________ in Misamis Oriental, Philippines.
 LEONIDES T. GAMOLO
Transferor/Vendor/ Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this _____ day of

_________________ in Misamis Oriental, Philippines, transferor/vendor exhibited
to me his Competent Evidence of Identity below his name.

Doc. No. ______;

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