AFFIDAVIT OF WAIVER OF RIGHTS

I, , of legal age, Filipino citizen, and a resident of Lower Maton, Pudtol, Apayao, after
having been sworn to in accordance with the law, do hereby depose and state that:

1. I am no longer interested over a parcel of land covered by Tax Declaration No. 06-
0013-00064 (Lot No. 4) located at Lower Maton, Pudtol, Apayao, containing an area
of Five Hundred (500) square meters;
2. I am voluntarily waiving my rights thereto and freely GIVE, TRANSFER and
CONVEY my rights and interests over the above-mentioned parcel of land in favor of
REX GUBSI;
3. I am executing this in utmost good faith fully aware of our rights under the laws and
free from any form of duress or coercion;
4. Further, I have executed this Affidavit to attest to the truthfulness of the foregoing
and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, I have set my hand this ___________ at at Pudtol, Apayao.

Transferor
ID No:

Signed in the presence of:

1. John Cena 2. Kelly Nabong

ACCEPTED BY:
BATISTA
PhilSys:3908-7196-6678-980

Republic of the Philippines )

)s.s.

ACKNOWLEDGEMENT

BEFORE ME, a notary public, on this ____________ , personally appeared the aforesaid
persons who exhibited to me their competent evidence of identities and known to me to be the same
persons who executed the foregoing instrument, and being informed by me of the contents of the said
instrument, acknowledged before me that they executed the same in their own free will and deed.

For the contents of the annexed document, the undersigned counsel assumes no responsibility
whatsoever.

IN WITNESS WHEREOF, I have hereunto set my hand on these presents and affixed my
Notarial seal on this day stated above at Pudtol, Apayao.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2024.