REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO ) Sc.

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

AFFIDAVIT OF ADVERSE CLAIM

Transfer Certificate of Title No. T-30158

We, SPOUSES NELSON V. CLIMACOSA and NANCY ALFECHE-CLIMACOSA, both

of legal age, Filipinos, and residents of B10 L2 and 3, Savannah Glen A, Pulo Maestra Vita,
Oton, Iloilo, after having been sworn to in accordance with law, depose and say, THAT:

1. We are the purchasers for value in good faith of a THREE HUNDRED SQUARE METER
(300 SQ.M.) PORTION out of the total area of 1,258 sq.m., more or less, area of a parcel of
land known as Lot No. 2604-B-4, situated at Mandurriao, Iloilo City, and registered in the
name of the Vendor, Elizabeth Reales, of legal age, single, under Transfer Certificate of
Title (T.C.T.) No. T-30158 of the Registry of Deeds for the City of Iloilo;

2. On August 17, 2016, at Iloilo City, the Vendor, Elizabeth Reales, and us executed a
Deed of Conditional Sale which was acknowledged on the same date at Iloilo City before
Notary Public Atty. Ernesto H. Mediodia and entered in his Notarial Register under Doc. No.:
54; Page No.: 12; Book No. ; Series of 2016. A copy of the said Deed is hereto attached
and made an integral part of this Affidavit;

3. We have already paid the Vendor the total amount of PESOS: FIVE HUNDRED
THOUSAND (Php 500,000.00), Philippine Currency, as downpayment of the purchase price;

4. However, on Sept. 19, 2016 and before full payment of the purchase price, the
Vendor, Elizabeth Reales, died intestate in Iloilo City and without any compulsory heirs; and
5. We are therefore executing this Affidavit to protect our rights and interests in T.C.T.
No. T-30158 to the extent of the 300 sq.m. area that we have purchased therein and to attest
to the truthfulness of the foregoing allegations in support of our request for the annotation of
an adverse claim in T.C.T. No. T-30158.

IN WITNESS WHEREOF, we have hereunto set our hands in the City of Iloilo,
Philippines, this ___________________________ .

NELSON V. CLIMACOSA NANCY ALFECHE-CLIMACOSA

Affiant Affiant

SUBSCRIBE AND SWORN to before me in the city of Iloilo this ________________,

affiants exhibiting to me their respective Competent Evidence of Identification:

1. Nelson V. Climacosa: Phil Passport No. EC6998459 valid until March 08, 2021;
2. Nancy A. Climacosa: Driver’s License No. F03-06-001738 to expire on April 14, 2017

Doc. No.: 217 ;

Page No.: 44 ;
Book No.: XX ;
Series of 2016.