REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SURIGAO DEL NORTE ) S.S.

MUNICIPALITY OF DAPA )

AFFIDAVIT OF ADVERSE CLAIM

I, ______________________, Filipino, of legal age, married and

residing at ___________________________, after having duly sworn in
accordance with law hereby depose and state that:

1. I am the same person mentioned above who have caused the

execution and preparation of this affidavit.

2. I am filing a Notice of Adverse Claim on the property located in

__________________ that is owned by
_____________________which is particularly described as
follows, to wit:

________________________________________________-

3. That originally, the above-described parcel of land was located in

____________________________and allegedly had a total land
area of not more than THREE (3) HECTARES and is adjacent to
the property owned and possessed by ___________________.

4. However, on the year 2008, when there was an adjustment and

transfer of the location of the said property from
_______________________, boundary dispute between
______________________and ____________________owned by
________________ started to accrued.

5. That from more or less Three (3) Hectares, the land area of Lot
Number __________________ suddenly increased to 7.4867
HECTARES.

6. That we were shocked that the land area of the adjacent property
owned and possessed by my father,
____________________decreased from TEN (10) HECTARES to
4.200700 HECTARES. (See Attached Copy of the Tax
Declaration of Real Property with TD No.
___________________)

7. ______________________________________

8. That we believe based on the circumstances, sequence of events,

and matters of facts that _________________________
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 encroaches and overlap with the property owned by
__________________due to its sudden increase in the land area
from more or less Three (3) Hectares to more than Seven (7)
Hectares.

9. That until now, the herein property believed to be the subject of the
dispute is still in our possession and under the claim of ownership.

10.With this development, I am executing this affidavit to serve as

notice to a third person that the herein property subject of the
dispute is in our possession and under the claim of ownership.

11.Further, I am praying that this particular claim of ownership be

duly noted and annotated thereof.

12.Finally, I am executing this affidavit to attest to the truthfulness

and veracity of the foregoing facts stated therein.

IN WITNESS WHEREOF, I have hereunto set my hands this

_______day of_________________, 2023 in________________________,
Philippines.

________________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this _____

day of ____________________, 2023
in_______________________________, affiant exhibiting her
__________________________ issued on _______________________ in -
_________________________. This is to certify further that the affiant has
executed voluntarily and understood his affidavit.

Doc. No. _______

Page No. _______
Book No. _______
Series of 2023

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