Republic of the Philippines)

Province of ____________________)S.S.
City/Municipality of _____________)
x------------x

AFFIDAVIT

I, _____________, of legal age, Filipino, (single / married / widow), and a

resident of _____________, Philippines, after having been duly sworn to in
accordance with law, hereby depose and state, that:

1.That I am the true and registered owner of a certain parcel of land which
is covered by Transfer Certificate of Title No. _____________, more
particularly described as follows:
(Technical Description of Property)

2.That annotated on said Transfer Certificate of Title No. _____________

are the following entries, to wit:

3.That the effectivity and efficacy of said entries have since expired as
shown by the dates thereon and/or were correspondingly superseded by
other entries which are also being caused to be cancelled in view of the fact
that the party to said annotation has registered no opposition to its
cancellation.

4.That I am executing this affidavit purposely requesting the Register

of Deeds to cause the cancellation of the above-mentioned entries in the
aforementioned Transfer Certificate of Title.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_____________ at _____________, Philippines.
Affiant

(JURAT)