REPUBLIC OF THE PHILIPPINES )

City of___________________________)S.S.

x-------------------------------------------x

AFFIDAVIT OF ADVERSE CLAIM
I, __________________________-, of legal age, Filipino, single, with registered office address
at _________________, __________City, after having been duly sworn to in accordance with law,
hereby depose and state:

1. That on ___________, a Lease Agreement/ Contract to Sell (Whichever is applicable)

(Agreement for brevity) a parcel of land was entered into by and between
________________________________ as LESSOR/SELLER (whichever is applicable) and I, for
and in behalf of representative of Solar Philippines, as LESSEE/BUYER. A Copy of this
Agreement is hereby attached as Annex “A” and is made an integral part hereof;

2. That the aforementioned Agreement involves a certain parcel of Land covered by Transfer
Certificate of Title (TCT) No. ______ and Tax Declaration No. ________________, more
particularly described as follows: (Put here the technical description as per TCT/TD)

__________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________;

3. That additionally, said Agreement was in fact acknowledged on _________________ before a

Notary Public, Attorney _________________ of _________________ and entered in his
Notarial Register as Doc. No, __, Page __, Book __, Series of __. A copy of the said contract
is hereto attached as Annex “A” and made an integral part hereof;

4. That pursuant to the Agreement, upon its execution or within two (2) years from date of the
Agreement, the LESSEE/BUYER shall obtain necessary regulatory permits pertinent to its
project including the corresponding annotation of the Torrens Title of the LESSOR/SELLER
with the Office of the Register of Deeds of _________ City;

5. That in relation to paragraph #4, the LESSOR/SELLER agreed to provide cooperation and
support to the permitting procedures of the LESSEE/BUYER which includes providing the
Owner’s Copy of the TCT;

6. Notwithstanding the above, the SELLER failed to provide the Original Owner’s copy of the
title within the period provided, hence the existence of the Agreement cannot be annotated
on the Title with the office of the Registry of Deeds.

7. That 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 Transfer Certificate of Title No.9342, located at Barangay
Malainen Luma, Naic Cavite, containing an area of 101,066 square meters.

     IN WITNESS WHEREOF, I have hereunto set my hand this _________ day of _________ in
_______________________, Philippines.

________________________-
Affiant
     
    SUBCRIBED AND SWORN TO before me this ____________ day of
___________________ in ___________________, Philippines, affiant exhibiting to me her Philippine
Passport No. ______________ issued in ___________ on _________________ and valid
______________________.
NOTARY PUBLIC
Doc No. ________;
Page No.________;
Book No._______ ;
Series of 2020.