Republic of the Philippines

)
Province of ________________
)S.S.
City/Municipality of ____________)
x-------- ---------------x
AFFIDAVIT OF ADVERSE CLAIM
I, _____________, of legal age, Filipino, (single / married /
widow), and a resident of _____________, after having been
sworn to in accordance with law, depose and say:
That the late ________________________________, was the
registered owner of a parcel of land (including the
improvements thereon) located at _____________, more
particularly described as follows:
(Technical Description of Property)
That on _____________, the late ________________________,
executed a Deed of Sale in my favor for valuable
consideration which document is more particularly identified
as Document No. ______, Page No. ______, Book No. ______,
Series of ______ in the Notarial Register of Notary Public
_____________ and a certified copy of which is attached herein
as Annex A.
However, it has very recently come to my knowledge that
_____________________, one of the heirs of the late
____________________________, is presently claiming to still
have an interest over the aforementioned parcel of land and
is attempting to sell or dispose of the same despite the fact
that the late ___________________ has already previously
conveyed to me all his rights and interests thereon on the
above-described property.
That unless an adverse claim is annotated on the aforedescribed Transfer Certificate of Title, the heirs of
_____________ are in danger of being defrauded and deprived
of their just and valid right over the afore0described parcel
of land and, as such, I am executing this Affidavit in support
of my request for the annotation of an adverse claim over
the parcel of land described herein.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand
this _____________, in the City / Municipality of _____________,
Philippines.
Affiant
JURAT
SUBSCRIBED AND SWORN TO BEFORE ME THIS
_____________, Affiant personally presented to me his
_____________ ID, bearing No. ________________, and
issued/expiring on __________________, issued at
_____________________, as avalid and acceptable proof of his
identity.
Doc. No. _______;
Page No. _______;
Book No. ______;
Series of 20____.