To: THE REGISTER OF DEEDS

Provincial Capitol, Telaje

Tandag City, Surigao del Sur

CITY ASSESSOR
Tandag City Hall
Tandag City, Surigao del Sur

DEPARTMENT OF AGRARIAN REFORM (DAR)

Tandurpass, Mabua, Tandag City
Surigao del Sur

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SURIGAO DEL SUR)S.S
CITY OF TANDAG)
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ADVERSE CLAIM
I, AMELITA S. MARTICION, of legal age, Filipino, and a resident of
Tandag City, Surigao del Sur, sworn to in accordance with law, hereby depose and
state, THAT:

1. I am the mortgagee of land owned by ESMERALDA P. SABLAS, ET.

AL, identified as Lot No. 2107, Cad-392-D, covered by Original Certificate of
Title No. C-100, measuring 20,925 Square Meters, situated at Pandanon, Tandag
City, Surigao del Sur;

2. Sometime on January 6, 1994 Bading Sablas one of the owner of

ESMERALDA P. SABLAS, ET. AL. A Good for or borrowed money in the
amount of P 8,500.00 with an interest 370 Kls Copras quarterly.

Copy of the GOOD FOR is herewith attached as ANNEX “A”, and made
integral part hereof;

3. After Eight (8) Months on the 1 st day of September 1994 ESMERALDA

P. SABLAS, ET.AL, executed a DEED OF SALE WITH RIGHT TO
REPURCHASE in the amount of TWENTY THOUSAND (P 20,000.00) PESOS
from me as VENDEE and stating therein that for the land subject of this
ADVERSE CLAIM.

Copy of which is herewith attached as ANNEX “B”, and made integral part
hereof;

4. Sometime on November 30, 1994, Esmeralda P. Sablas one of the owner

demanded an additional amount to mortgage the subject land to me in the amount
of TWENTY FIVE THOUSAND FIVE HUNDRED (P 25,500.00) PESOS, and
signed by Esmeralda P. Sablas and her husband Juanito Sablas;
 Copy of which is herewith attached as ANNEX “C”, and made integral part
hereof;

5. However until now Esmeralda P. Sablas, Et. Al. have not recovered the
mortgage land and to repurchase the same according to the DEED OF SALE
WITH RIGHT TO REPURCHASE executed by Esmeralda P. Sablas, Et. Al.
almost 26 years has been already passed since the execution of this mortgage.

6. Recently, ESMERALDA P. SABLAS decided to Transfer the Certificate

Title of this subject land under the name of her son and attempted to dispose of the
same to interested buyers;

7. We hereby declare our adverse claim over her position in said property,
and request your good office to annotate this CLAIM, to protect our rights and
interests, and give notice to any potential buyer of our right. Kindly register this
adverse claim in the manner provided by law.

We further request your good office to deny access to and refuse issuance of
documents pertaining to this property without our express and written consent;

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___

day of ________________ at Tandag City, Surigao del Sur.

AMELITA S. MARTICION
Petitioner/Affiant
____________________

SUBSCRIBED AND SWORN TO before me, in the City of Tandag,

Surigao del Sur, this ____ day of _______________, the affiant exhibited her
proof of identity with photograph as indicated above.

Doc No ___
Page No ___
Book No ___
Series of 2021.