Republic of the Philippines)

Province of Negros Oriental) S.S.

CITY OF DUMAGUETE)
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AFFIDAVIT OF SELLERS/TRANSFERORS
I, of legal age, Filipino, and resident of Philippines, after
hereby been duly sworn to in accordance with law, do hereby
depose and say:
That the land we sold/donated to with an area of
_____________, under Doc. No. ______, Page No.______, Book No.
______, Series of 2016, of Notary Public ________, dated __________,
is my retention or a portion of my retention area of not more than
five (5) hectares;
That this affidavit is executed in compliance with DAR
Administrative Order No. 1, Series of 1989 as well as to show
proof that the land subject of the above-mentioned transaction is
a retention or portion of a retention area, and that the land is not
tenanted.
AFFIANTS SAYETH NONE.
____________________
(Place)
____________________
(Date)
Affiant
SUBSCRIBED AND SWORN to before me on this
___________, at Dumaguete City, Negros Oriental, Philippines,
affiants exhibited to me his _____________ as proof of his identity.
Doc. No. _____
Page No._____
Book No._____
Series of 2016.