Republic of the Philippines ]

City of Tagbilaran ] S.S.

AFFIDAVIT OF ADJOINING OWNERS

We, ________________________ and ________________________ both Filipinos, of

legal age, and residents of ___________________, Philippines, after being duly sworn in
accordance with law, hereby depose and say:

1. That we personally knew the late __________________ who was the survey claimant /
tax declarant of a parcel of land designated as Lot No. ______ located at
_____________________, containing an area of _______________ (______) SQUARE
METERS, more or less;

2. That we are the adjoining lot owners of the above property;

3. That to the best of our knowledge, belief and information, the said land had been
originally occupied and cultivated by __________________ for more than thirty (30)
years already in the concept of an owner;

4. That we are not related with him either by consanguinity nor affinity, nor are we
interested in any capacity whatsoever over that parcel of land; and,

5. That we execute this affidavit voluntarily with full understanding to attest to the truth of
the foregoing statements and to support the approval of the Free Patent Application.

IN WITNESS WHEREOF, we hereunto set our hand this _________________ at

Tagbilaran City, Bohol, Philippines.

_____________________________ _____________________________
Valid ID: Valid ID:

Attested by:

__________________________
Punong Barangay, ____________________

SUBSCRIBED AND SWORN to before me this _______________ at

_______________________, Philippines.

Doc. No. ________;

Page No. ________;
Book No. ________;
Series of 2020.