Republic of the Philippines )

Tagum City, Davao del Norte ) ss.

x------------------------------------------------------x

AFFIDAVIT OF CANCELLATION
OF ADVERSE CLAIM
I, _______________________, Filipino, of legal age, married to _______________________, and a
resident of _______________________, Philippines, under oath, depose and state that:

I am the purchaser and present owner of a parcel of land identified as

_______________________;

That an Affidavit of Adverse Claim was annotated as Entry No. _______________________

dated _______________________ at the back of _______________________ which reads as follows:

EXECUTED BY _______________________, OF LEGAL AGE, FILIPINO,

MARRIED AND A RESIDENT OF _______________________, CLAIMING AGAINST
THIS PROPERTY, IN ACCORDANCE WITH DOC. NO. ____; PAGE NO. ___; BOOK
NO. ___; SERIES OF _____; OF THE NOTARY PUBLIC OF TAGUM CITY; ATTY.
_______________________; DATED _______________________.

I hereby request the Registry of Deeds of the Province of Davao del Norte to cause
the cancellation of the annotation of the Affidavit of Adverse Claim or Notice of Adverse
Claim annotated on Transfer Certificate Title No. _______________________;

I am executing this affidavit to attest to the truth and veracity of all the foregoing
and for all legal other legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day of February,

2020 at Tagum City, Davao del Norte.

_______________________
_______________________

SUBSCRIBED AND SWORN to before me on the same date and place above.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of _____.