REPUBLIC OF THE PHILIPPINES )

CITY OF BUTUAN )S.S.

AFFIDAVIT OF NO TITLE

I, MARIA ELENA H. MEDINA, Filipino, of legal age, and a resident of Purok 1, Brgy.
Bonbon, Butuan City, after having been subscribed to an oath, depose and say, THAT:

1. I am the actual possessor and occupant in the concept of an owner of certain

residential lot located at Brgy. Bonbon, Butuan City, denominated as Lot No.
146-B-372 containing an area of Two Hundred Sixty-Five (265) square meters,
more or less, and covered by Tax Declaration of Real Property No. 20-07-0001-
01852 of the Office of the City Assessor of Butuan City;

2. I declare that the said parcel of land is not registered with the Register of Deeds
and thus No Title has been issued pertaining to such parcel of land;

3. Based on available DENR record, the abovementioned property is situated

within alienable and disposable land and not within any reserved lands for the
public domain;

4. To the best of my knowledge, the property is free from any lien or encumbrance;

5. I have never been accused of and/or administratively or criminally charged with

false testimony or perjury in any office, court or tribunal; and

6. I am executing this Affidavit to attest to the veracity of the abovementioned facts

thereby satisfying the requirements of government agencies relative to my
application of a corresponding certificate of title.

IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of

____________________ 2022 at Butuan City, Philippines.

MARIA ELENA H. MEDINA

Affiant

SUBSCRIBED AND SWORN to before me this ______ day of ____________________

2022, at Butuan City, Philippines. Affiant exhibiting to me his evidence of identity.

DELMER LAGASCA RIPARIP

Doc. No. ______ ; Notary Public
Page No. ______ ; Roll of Attorneys No. 66714 (May 23, 2017)
Book No. X ; IBP OR No. 172477 (Jan 07, 2022)
Series of 2022. PTR No. BC 2175665 (Jan 03, 2022)
MCLE Compliance No. VI-0007798
MCLE Compliance No. VII-0011677
TIN 924-782-121-000
Email add: delmer.riparip@yahoo.com
Mobile No. 09483603708