THE CHIEF

Municipal Agrarian Reform Officer

DAR, Goa, Camarines Sur

MADAM:

I Have the honor to request for DAR CLEARANCE at Balaynan, Goa, Camarines
Sur. This parcel of lands covered by TCT No. 2010000128, TCT No. 20100000113 and
TCT No. 20100000114 on the name of JUAN FIDEL A. PAN III, from I acquired the Lan
on _____________________________.

Together with the request are the necessary requirements in support hereof.

1. DEED of SALE
2. TAX DECLARATION
3. Certification of Land Holding of Buyer / Mun. / Provincial Assessor
4. Certification of Land Holding of Seller/ Mun. / Provincial Assessor
5. Affidavit of buyer
6. Affidavit of Seller
7. Electronic Xerox copy of title
8. Sketch Plan

I anticipate your usual favorable action on this matter.

Very truly yours,

JUAN FIDEL A. PAN, III

Seller
Republic of the Philippines )
Province of Camarines Sur ) S.S.
Municipality of __________)

AFFIDAVIT OF BUYER

I, CHRISTINE R. KIEGER, of legal age, married, Dual Citizens with

residence and postal address at Balaynan, Goa, Camarines Sur, after having
been duly sworn to in accordance with law, hereby depose and say:

That I am sole owner of three parcel of Land situated at Balaynan, Goa,

Camarines Sur, containing an areas of TWENTY SIX THOUSAND FOUR
HUNDRED EIGHTY (26,480) square meters., under TCT No. 2010000128,
SEVENTEEN THOUSAND SEVEN HUNDRED TWENTY FIVE (17,725) square
meters under TCT No. 2010000113 and TEN THOUSAND NINE HUNDRED
FIFTY FIVE (10.955) square meter under TCT No. 2010000114 from the
registered owner JUAN FIDEL A. PAN, III under Doc. No. _______,
Page no. ______ Book no._______ series of 2020 of Notary Public
Atty _________________ dated__________

That I have total land holding including the land brought as afore.
mentioned of not more than Five (5) hectares;

That I am executing this affidavit in compliance with DAR Administrative

Order no. I, series of 1989 as well as to show proof that our land holding does
not exceed Five (5) hectares.

AFFIANT SAVETH NONE.

MANUEL TAPANG CHRISTINE R. KIEGER

BARC CHAIRMAN BUYER

CATHERINE R. RAMOS
ATTORNEY-IN-FACT
Republic of the Philippines )
Province of Camarines Sur ) S.S.
Municipality of __________)

AFFIDAVIT OF SELLER

I JUAN FIDEL A. PAN III, of legal age, married with residence and postal
address at II 127-B Cadena de Amor Street, United Parañaque IV Subd.,
Barangay Marcelo Green, Parañaque City, after having been duly sqorn to in
accordance with Law, hereby depose and say;

That the land I sold to CHRISTINE R. KIEGER with an area of TWENTY

SIX THOUSAND FOUR HUNDRED EIGHTY (26.480) square meters, under
TCT No. 2010000128, SEVENTEEN THOUSAND SEVEN HUNDREDD
TWENTY FIVE (17.725) square meters under TCT No. 2010000113 and TEN
THOUSAND NINE HUNDRED FIFTY FIVE (10.955) square meters under TCT
No. 2010000114 under Doc. No. _______, Page no. ______ Book no._____
series of 2020 of Notary Public Atty __________________ dated__________., is
my retention areas of not more than Five (5) Hectares;

That I am executing this affidavit 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 portion as a retention area.

AFFIANT SAVETH NONE.

MANUEL TAPANG JUAN FIDEL A. PAN III

BARC CHAIRMAN SELLER

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2020

at _______________________, Camarines Sur.