AFFIDAVIT OF OWNERSHIP

(BY EXTRAORDINARY PRESCRIPTION)

I, [FULL NAME], of legal age, Filipino citizen, married to [FULL NAME], Filipino
citizen, with residence and postal address at [Address], after having been sworn to in
accordance with law, hereby depose and say:

1. That I am in possession of a parcel of land containing an area of

______________ (_______) SQUARE METERS located in the Province/City of
_____________, and bounded by [description of boundary properties]. (hereafter
“Subject Lot”)

2. That I entered into possession of the Subject Lot since [Date] by virtue of [deed
of sale, occupation, etc.] and, since then up to the present time, or for a period
exceeding thirty [30] years, have remained in continuous, adverse, peaceful,
and exclusive possession of the Subject Lot in the concept of owner.

3. That I have exercised my rights as owner of the Subject Lot by paying the real
property taxes on the said property from [Year] until the present date.

4. That to the best of my knowledge, the Subject Lot has not been the subject of
registration in the name of any other person and no person has any legitimate
claim on the property adverse to mine.

5. That I am executing this affidavit to attest of the truth of foregoing facts;

6. That I am further executing this affidavit as a compliance of the requirements

of Registry of Deeds for the Province/City of _____________ for the registration of
the land and application of title in my name and for whatever legal purpose it
may serve.

IN WITNESS WHEREOF, I have to affixed my signature on this _____ day of _____ at

_______________ City, Philippines.

[Name and Signature]

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of _________, 20_____ at

_________________ City, Philippines, affiant exhibiting to me his competent proof of
identity in the form of [government issued ID type/number/date and place of issue] .
NOTARY PUBLIC

Doc. No. _____ ;
Page No. _____ ;
Book No. _____ ;
Series of _____ .