REPUBLIC OF THE PHILIPPINES) ____________________________) S.S.

AFFIDAVIT OF NO IMPROVEMENT

I, _____________________________, of legal age, Filipino, single/married, and resident of _______________________________________, after being sworn according to law, hereby depose and state that: 1. I am the registered owner of a parcel of land situated at

_______________________________________, covered by Transfer Certificate of Title No. __________ of the Registry of Deeds for _____________________, containing an area of _________ square meters, more or less. 2. The above parcel of land is a vacant lot since there are no improvements

or structures built thereon whatsoever. 3. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purpose this may serve.

AFFIANT FURTHER SAYETH NAUGHT.

[Signature above Printed Name] Affiant SUBSCRIBED AND SWORN to before me this _____________________ at _________________________, affiant exhibited to me his/her Competent Evidence of Identity by way of ____________________ issued at ___________________ on _______________________.

Doc. No. ______; Page No. ______; Book No. ______; Series of ______.