Republic of the Philippines )

Province of Batangas ) S.S.

_________________________________)

AFFIDAVIT OF HEIRS/NON-TENANCY & NO PENDING CASE

I/We,________________________________, of legal age, Filipino, married/single and

residing at __________________________________________, after having been duly sworn in
accordance with law, hereby depose and state:

That the total landholdings of our deceased parents are their retention or portion of their
retention area of not more than five (5) hectares.

That as legal heirs our total aggregate landholdings including the area of
_______________________ that we inherited from them under under Doc. No. ______________,
Page No. ________, Book No. ________, Series of 20_____, of Notary Public Atty.
__________________________________________ dated ____/____/_______ is my/our
retention area of not more than five (5) hectares.

That the said parcel of land has NO PENDING CASE

That this affidavit is executed in compliance with DAR Administrative Order No. 4,
series of 2021, as well as to show proof that our aggregate landholding inclusive of the land
subject for inheritance does not exceed five (5) hectares and the same is NOT TENANTED.

AFFIANT SAYETH NONE

AFFIANT

SUBSCRIBED AND SWORN TO BEFORE ME this ________ day of _____________,

at ________________________________ by the affiant who exhibited to me his/her valid
Identification ____________________________.

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