7/23/2019 Affidavit Cancellation Entry

1/1

Republic of the Philippines)

Province of ____________________) S.S.

City/Municipality of _____________)x - - - - - - - - - - - - - - - - - - - - - - - x

HO. R!"#S$!R O% &!!&S

_________________________

_________________________

'%%#&'(#$ O% C'C!'$#O O% !$R*

#+ ___________________________+ of le,al a,e+ %ilipino+ sin,le / arrie /

0io0)+ an a resient of _________________________+ Philippines+ after havin, been

uly s0orn to in accorance 0ith la0+ hereby epose an state+ that1

2. # a the true an re,istere o0ner of a certain parcel of lan 0hich is covere by$ransfer Certificate of $itle o. _____________+ an ore particularly escribe as

follo0s1

$C$ O. _______________________

$echnical &escription of Property)

3. 'nnotate on the$ransfer Certificate of $itle o. _____________ are the follo0in,

entries+ to 0it1

4. $he effectivity an efficacy of sai entries have lon, expire as sho0n by the ates

thereon an/or 0ere corresponin,ly supersee by other entries 0hich are also bein,

cause to be cancelle in vie0 of the fact that the party to sai annotation has re,istereno opposition to its cancellation.

5. $hat # a executin, this affiavit purposely re6uestin, the Re,ister of &ees to causethe cancellation of the above-entione entries in the aforeentione $ransfer

Certificate of $itle.

# 7#$!SS 7H!R!O%+ # have hereunto affixe y si,nature this

_____________ at _____________+ Philippines.

'ffiant

S89SCR#9!& '& S7OR $O 9!%OR! M! this ___ ay of ___________+

3:2;+ in the City of _____________+ Philippines+ affiant personally presente to e his_______ #& expirin, on _________+ issue at __________+ as vali an acceptable proof

of his ientity.

&oc o. _____