Republic of the Philippines)

Baguio City )
x----------------------------------x

AFFIDAVIT OF TRANSFEROR /
TRANSFEREE

We, SPS. LARRY & MARILYN NGALES and SPS. LUIS & HELGA PINASEN, of legal ages,
Filipino citizens and a resident of La Trinidad and Baguio City respectively, under oath, depose and
state, viz –

1. We are the respective transferors and transferees of a landholding located in Brgy.

Ambiong, Municipality of La Trinidad, Benguet by virtue of that Deed of Sale of a
registered land under Doc. No.____; Page No. ____; Book No. ____; Series of ____; of the
Notarial Registry of MILTON L. BALAGTEY of Baguio City dated ___ day of
___________, 20__;

2. The total landholding including the aforesaid parcel of land acquired does not exceed
Five (5) hectares;

3. That the land subjects of the transaction is a retention or portion of the retention area
of the transferor;

4. This affidavit is executed in compliance with DAR Administrative Order No. 1 series
of 1989, as well as to show proof that the aggregate total landholding inclusive of the
land subject of the above-named transaction does not exceed Five (5) hectares; and

5. We are executing this affidavit to attest to the truthfulness of the foregoing narration
of facts and for all legal intents and purposes that this affidavit may serve.

IN WITNESS WHEREOF, I hereunto set my hand this __ day of ___________ 20__ in Baguio
City, Philippines.

LARRY P. NGALES MARILYN L. NGALES

(Transferor) (Transferor)

LUIS PINASEN HELGA PINASEN

(Transferee) (Transferee)

SUBSCRIBED and SWORN to before me at Baguio City, Philippines this ___ th day of __________, 20__
by the above affiants who are personally known and identified by me based on competent evidence to be the
same persons who freely and voluntarily executed the above affidavit.

WITNESS MY HAND AND SEAL.

Noted by:
___________________
(BARC CHAIRMAN)
Barangay Ambiong, Municipality of La Trinidad,Benguet