DAR CLEARANCE FORM 4.

Republic of the Philippines )

City/Mun. of ______________________ ) S.S.
Province of Cebu )

AFFIDAVIT OF NON-TENANCY

I, _______________________________________________________, Filipino, of legal

age, and residing at __________________________________________________, after having
been duly sworn to, in accordance with law, do hereby depose and state-THAT:

1. We are the true and lawful owners of the parcel of land known as:

Lot No.
Area of
Located at
Under OCT/TCT No.
Tax Declaration No.

2. As owner of the lot/s, I conveyed the same to the TRANSFEREE:

____________________________________________________

3. I hereby warrant that the subject lot conveyed to the TRANSFEREE is not tenanted
agriculturally and/or has no agricultural tenant in possession and cultivation thereof;

4. I am executing this affidavit of non-tenancy to attest to the truth of the foregoing

facts and to prove, manifest and declare that indeed the subject lot has no tenant
thereof and as a supporting document for the application of DAR Clearance.

IN WITNESS WHEREOF, I have hereunto set my hand this ______________ , in the

City/Municipality of __________________ , Cebu, Philippines.

_______________________________
Affiant
(Signature over printed name)

CTC/ID No. ;
Issued at ;
Issued on ;

SUBSCRIBED AND SWORN to before me at the date and place above-written.

Affiant exhibited to me his/her CTC/ID No. as written above.

Doc. No. ______;

Page No. ______;
Book No. ______; NOTARY PUBLIC
Series of 20____.