Republic of the Philippines)City of Santiago )SS.x- - - - - - - - - - - - - - - -x

AFFIDAVIT OF ADVERSE CLAIM

         I, ____________________________, of legal age, Filipino, single and a resident of _________________________, after having been duly sworn to in accordance with law, depose and state, THAT:

1. On _______________________, I have entered into a Deed of Conditional Sale which was acknowledged on the same date before Notary Public ____________________ of Santiago City and entered in his Notarial Register as Doc. No. ___, Page___ Book ____, Series of 20___. A copy of the said  Deed is hereto attached as ANNEX “A” and made an integral part of this Affidavit;

2. In the said Deed of Conditional Sale, I was the VENDEE of a certain parcel of land covered by Transfer Certificate of Title No. ________________________, more particularly described as follows:

(Technical Description of Property)

3. That because I still have a balance on the purchase price in the amount of _____________ which is payable within one (1) (year) from the date of signing thereof, it was stipulated in the aforementioned Deed that title and ownership over the subject property will only be transferred upon full payment of the same;

4. That the VENDOR in the said Deed of Conditional Sale agreed that upon its execution, said Deed shall be annotated in the Title with the Office of the Register of Deeds of Isabela;

5.  However, since the said Deed of Conditional Sale per se could not be annotated on the Title with the Office of the Register of Deeds, I am therefore executing this Affidavit for the purpose of attesting to the truthfulness of the foregoing allegations and in support of my request for the annotation of an adverse claim over the parcel of land covered by Transfer Certificate of Title No. ____________.

     IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of _____________________ at Santiago City, Philippines.          

________________Affiant

SUBCRIBED AND SWORN TO before me this ____day of ______________ at Santiago City, Philippines, affiant exhibiting to me his/her _________________________ a competent evidence of identity, issued at _______________________ on ________________ and valid until __________________.

Doc. No. _____;Page No. _____;Book No. _____;Series of 20___.