REPUBLIC OF THE PHILIPPINES)
_______________________ ) S.S.

AFFIDAVIT OF ADVERSE CLAIM

I,  (Name of Affiant) , Filipino, of legal age, with residence and postal address at _______________________, after having been sworn to in accordance with law, hereby depose and say:

1. That  (Name of Vendor)  accepted an Offer to Purchase from the undersigned over that certain property covered by Transfer Certificate of Title No. ________ of the _________ Registry of Deeds, more specifically Lot __________________, Block ___________________ and or _________ ( address )________.
   
 
2. That pending the finalization of the sale over the aforesaid property (see Annex "B" copy of Offer to Purchase) , the undersigned is unable to effect the transfer of the title in her name pursuant to the conditions of sale imposed by  ( Name of Vendor ) .
   
   
3. That this affidavit is being executed in order to attest to the veracity of the foregoing and in order to have the claim of  ( Name of Affiant )  annotated in TCT #________.

FURTHER AFFIANT SAYETH NAUGHT

_________________________

Affiant

Witnesseth By:

_______________________________

SUBSCRIBED AND SWORN to before me this ____ day of ______, 20___ at ________, Cebu, Philippines, affiant exhibited to me her/his Community Certificate No. ________ issued at ________ on ______________.

NOTARY PUBLIC
Until December 31, 20_____

Doc. No. ______
Page No. ______
Book No. ______
Series of _______

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