REPUBLIC OF THE PHILIPPINES)

PROVINCE OF PANGASINAN )S.S.

CITY OF ALAMINOS )
X - - - - - - - - - - -- - - - -- - - - - - - -- - X

AFFIDAVIT OF ADVERSE CLAIM

That I, GERONCIO B. LOPEZ, of legal age, Filipino Citizen, married, and a resident of
Telbang, Alaminos City, Pangasinan, Philippines, after having been duly sworn to in accordance with
law, do hereby depose and say;

That I am the vendee of a certain parcel of land, situated at Telbang, Alaminos City,
Pangasinan, Philippines, more particularly described as follows;

“A parcel of land located at Telbang, Alaminos City, Pangasinan, containing an

area of 1,290 square meters more or less; declared under TD No. 2018-38-01446.
Covered by KOT blg. Carp2018000249.”

That the evidence of transfer of ownership was the Deed of Absolute Sale duly executed
by DOLORES REYNALDO DIGMA, under the Notarial Register of Atty. Ernesto P. Tabara,
under Doc. No. 241; Page No. 49; Book No.-22, Series of 2018;

That I cannot register my said Deed of Absolute Sale due to the fact that lack of number
of years of ownership; and to protect my rights, an affidavit of Adverse claim can do to Adverse
Claim the property;

That I am executing this affidavit to attest to the fact that what I am saying are the truth
and I am requesting the good office of the Register of Deeds to annotate my interest at the back
of KOT No. Carp2018000249 and for any legal intent it may best serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _______________ at

Alaminos City, Pangasinan, Philippines.

GERONCIO B. LOPEZ
AFFIANT

SUBSCRIBED AND SWORN TO before me this ________________ at Alaminos City,

Pangasinan, Philippines.

Doc. No. ____

Page No. ____
Book No. _____
Series of 2014