Republic of the Philippines)

Province of Davao del Norte)S.S.

City/Municipality of Tagum City)
x------------x

AFFIDAVIT OF ADVERSE CLAIM

I, VELGIN M. PELAYO, of legal age, married, Filipino, and a resident
of Purok Nazareno, Prk Mangga, Brgy. Visayan Village, Tagum City,
Philippines, after having been duly sworn according to law depose and say:

1. That I am one and the same person executing this affidavit whose
circumstances are above stated;

2. That sometime on June 10, 2014, Angela Cruda-Pala, Dionisia Cruda

and Analou Cruda executed a document covering the loan of ONE HUNDRED
EIGHT THOUSAND (P108,000.00) PESOS, to be paid in installment basis;

3. That to insure the payment of the loan Dionisia Cruda delivered to

me her Katibayan ng Orihinal na Titulo Blg. 29141. Copy of the title is hereto
attached and marked as Annex “A” and formed integral part of this
affidavit;

4. That Angela Cruda-Pala, Dionisia Cruda anf Analou Cruda failed to

pay their loan despite several oral and written demands;

5. That to preclude Dionisia Cruda from petitioning in court for “Loss of

Title, I am executing this affidavit to inform the Office of the Register of
Deeds that the owners duplicate copy of Katibayan ng Orihinal na Titulo
owners duplicate copy is in my possession which I may file an attachment
suit soon;

6. That I am executing this affidavit to attest the truth of the above

allegation and to inform the Office of the Register of Deeds that KOT Blg T-
29141 is in my possession.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1st

day of February, 2019 at Tagum City, Davao Del Norte, Philippines.

VELGIN M. PELAYO
Affiant

SUBSCRIBED AND SWORN to before me at Tagum City, Davao Del

Norte, Philippines, this 1st day of February, 2019, and affiant exhibited his
competent evidence of identity in the form of his CRN – 0006-1341719-0.

ATTY. MATIAS T. AQUIATAN

Doc. No. 23; Notary Public
Page No. 5; Until December 31, 2019
Book No. 81: PTR No. 2472496 Jan.
03, 2019
Series of 2019 IBP OR # 24512 Jan.
08, 2018
 Roll No. 32402 May, 1983
TIN NO.
911-021-151