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Republic of the Philippines )

) S.S

____________________________________________, both of legal age, Filipinos and residents
of ___________________________________________, after being sworn under oath do hereby
state the following facts and circumstances:
1. That I, together with my spouse shall not have an aggregate agricultural landholding
ownership above five (5) hectares as a result of the proposed transfer;
2. That the proposed transfer is not intended to circumvent the aggregate agricultural
landholding ceiling rule;
3. That, in case the land is under agricultural leasehold prior to the transfer, and the previous
owner failed to inform the agricultural lessee, I will immediately inform the said lessee in
writing of such transfer and that I am waiving the defense for purposes of redemption
cases under Section 12 of R.A. No. 3844, as amended, of the registration of my Title as
judicial notice to the lessee as to the fact of the transfer; and
4. We are attesting to the truth of the foregoing and we are executing this affidavit for
whatever legal purposes it may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this ____ day of August,
2016 at ________________________.
Affiant (1)

Affiant (2)

SUBSCRIBED AND SWORN to before me this _____ day of August, 2016 at

Doc No. ____;
Page No. ____:
Book No.____;
Series of 2016.