AFFIDAVIT OF ADVERSE CLAIM

I, MARIE B. DELA CRUZ, of legal age, Filipino, single and a resident of 2223 Washington
Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law,
depose and state:
1. That on July 10, 2013, I have entered into a Deed of Conditional Sale which was acknowledged
on the same date before Notary Public Juan Tamad of Makati City and entered in his Notarial
Register as Doc. No. 2, Page 2, Book II, Series of 2013. A copy of the said Deed is hereto
attached as ANNEX A and made an integral part of this Affidavit;
2. That in the said Deed of Conditional Sale, I was the VENDEE of a certain parcel of land covered
by Transfer Certificate of Title No. 111222, more particularly described as follows:
(Technical Description of Property)
3. That because I still have a balance on the purchase price in the amount of P500,000.00 which
is payable within one (1) (year) from the date of signing thereof, it was stipulated in the
aforementioned Deed that title and ownership over the subject property will only be
transferred upon full payment of the same;
4. That the VENDOR in the said Deed of Conditional Sale agreed that upon its execution, said
Deed shall be annotated in the Title with the Office of the Register of Deeds of Makati City;
5. However, since the said Deed of Conditional Sale per se could not be annotated on the Title
with the Office of the Register of Deeds, I am therefore executing this Affidavit for the
purpose of attesting to the truthfulness of the foregoing allegations and in support of my
request for the annotation of an adverse claim over the parcel of land covered by the Transfer
Certificate of Title No. 111222.
IN WITNESS WHEREOF, I have hereunto set my hand this 26th day of September 2013 in
Makati City, Metro Manila, Philippines.

MARIE B. DELA CRUZ

Affiant

SUBCRIBED AND SWORN TO before me this 26th day of September 2013 in Makati City,
Metro Manila, Philippines, affiant exhibiting to me her Philippine Passport No. 123456 issued
in Manila on January 12, 2012 and valid until January 12, 2017.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2013.