(Adverse Claim for Transferred Rights over Real Property)

REPUBLIC OF THE PHILIPPINES)

Province of ____________________) S.S.

City/Municipality of _____________)

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

AFFIDAVIT OF ADVERSE CLAIM

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

resident of _____________, after having been sworn to in accordance with law, depose
and say:

1. That I am one of the heirs of the late _____________.

2. That a certain _____________ previously entered into a Deed of Conditional

Sale with the (Government Service Insurance System (GSIS) or Pag-IBIG)
for the purchase of a parcel of land (including the improvements thereon)
located at _____________, more particularly described as follows:

(Technical Description of Property)

3. That on _____________, _____________ executed a (Deed of Transfer of Rights

/ Assumption of Obligations) in favor of the late _____________, which
document is more particularly identified as Document No. ______, Page No.
______, Book No. ______, Series of ______ in the Notarial Register of Notary
Public _____________ and a copy of which is attached herein.
 4. That in said (Deed of Transfer of Rights / Assumption of Obligations),
_____________, for valuable consideration received, CEDED, TRANSFERRED
AND CONVEYED to _____________, his heirs, successors and/or assigns, all
his rights, interest and participation in the purchase of the aforedescribed
parcel of land.

5. That as such, _____________ has since then relinquished all his rights,
interest and participation over the aforedescribed parcel of land in favor of
the late _____________ and his heirs.

6. However, it has come to my knowledge that _____________ is presently

claiming to still have an interest over the aforementioned parcel of land
and is attempting to sell or dispose of the same despite the fact that he
has already conveyed all his rights and interests thereon to _____________
and his heirs.

7. That unless an adverse claim is annotated on the aforedescribed Transfer

Certificate of Title, the heirs of _____________ are in danger of being
defrauded and deprived of their just and valid right over the
aforedescribed parcel of land and, as such, I am executing this Affidavit in
support of my request for the annotation of an adverse claim over the
parcel of land described herein.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________, in the

City / Municipality of _____________, Philippines.

AFFIANT
(JURAT)