REPUBLIC OF THE 

PHILIPPINES)
________________________) S.S.
x-------------------------------------x
AFFIDAVIT OF ADVERSE CLAIM

         I, EULALIA CORONAS BOLONOS, of legal age, Filipino, widow and a resident of Purok
5, Barangay Sobrecary, Davao City, after having been duly sworn to in accordance with law,
depose and state that:

1.I am one of the Heirs, being one of the grandchildren of the late MODESTO REBUCAS, who
was the declared owner of the parcel of land situated at Macaas, Tubigon, Bohol identified as
Lot 7308 with an area of FIVE THOUSAND TWO HUNDRED FORTY-EIGHT (5,248) Square
Meters, more or less, presently covered by Tax Declaration 2998-44-0017-00658;

2. My mother is JOSEFA REBUCAS OMANIA, daughter of MODESTO REBUCAS who is

likewise the father of MAXIMIANO REBUCAS, all deceased;

3. Our first degree cousin, VIOLETA REBUCAS PILOTOS, daughter of MAXIMIANO REBUCAS
instructed me and my sister, PASTORA C. PULVIRA to sign the Extra-Judicial Settlement and
Partition of Real Estate of the Late Modesto Rebucas purportedly to settle the share of her
father (Maximiano) which is a separate parcel of land located at “Bood”, Macaas, Tubigon,
Bohol but not the parcel of land being described above;

4. I only learned last July 30, 2019 that Violeta Rebucas Pilotos produced an Extra-Judicial
Settlement and Partition of Real Estate of the Late Modesto Rebucas purportedly containing our
signatures and already describing Lot 7308 as the one being settled and partitioned;

5. The said Extra-Judicial Settlement and Partitioned was Notarized by Atty. ELMER SALUS B.
POZON last February 14, 2013 without our knowledge and presence.

6. Violeta Rebucas Pilotos is now applying for Title under free patent on her purported share on
the said fictitious Extra-Judicial Settlement.;

7. The subject Lot No. 7308 is the share of JOSEFA REBUCAS OMANIA, SOTERA REBUCAS,
and PEDRO REBUCAS, all deceased children of MODESTO REBUCAS;

8. The share of the other children namely: MAXIMIANO REBUCAS, CUSTODIO REBUCAS,
TEODORA REBUCAS, and ELEUTERIO REBUCAS is not the land with Lot. No. 7308 as
described above but the land with Tax Dec No. 27694 located in a place called “Bood” in
Barangay Macaas, Tubigon, Bohol;

9. In view of the foregoing therefore, and in order to protect our interest, I am hereby formally
filing this Adverse Claim / Protest on the Free Patent Application of VIOLETA R. PILOTOS over
the subject lot;

10. I am executing this Affidavit of Adverse Claim to support my above claim and for the
purpose of filing the same at the Office if the Department of Environment and Natural
Resources (DENR), Tagbilaran City, the Register of Deeds, the Assessor’s Office of the
Municipality of Tubigon, and wit all other government offices and agencies concerned.
11. I am executing this affidavit to establish and attest above facts and for whatever legal
purpose this may serve.

     IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of August, 2019 in
_______________________, Bohol, Philippines.
          

EULALIA C. BOLONOS
Affiant

    SUBCRIBED AND SWORN TO before me this ____ day of August, 2019  in ____________,
Bohol, Philippines, affiant exhibiting to me her Philippine SSS ID No. 09-1849280-0.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019. 
Republic of the Philippines)
______________________) S.S.

VERIFICATION / CERTIFICATION

I, EULALIA CORONAS BOLONOS, of legal age, Filipino, widow and a resident of Purok
5, Barangay Sobrecary, Davao City, after having been duly sworn to in accordance with law,
hereby depose and state, that;

1. I am the Adverse Claimant in the instant case.

2. I caused the preparation of an Affidavit / Adverse Claim and that I have read the
allegations therein and found the same to be true and correct to the best of my
personal knowledge and based on authentic records.

3. I further certify that I have not commenced any other action or proceeding involving
the same issue in the Supreme Court, the Court of Appeals or other tribunal or
agency; to the best of my knowledge no such action or proceeding is pending in the
aforesaid courts, tribunal or agency and that if I should learn that a similar action or
proceedings has been filed or pending before such courts, tribunal or agency, I shall
report such fact within five (5) days therefrom.

IN WITNESS WHEREOF, I have hereunto set my signature this _____ day of August, 2019 in
_______________, Bohol Philippines.

EULALIA C. BOLONOS
Affiant
SSS. ID. No. 09-1840280-0

    SUBCRIBED AND SWORN TO before me this ____ day of August,

2019 in ____________,Bohol, Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.