REPUBLIC OF THE PHILIPPINES)

______________
) S.S.
______________
)
x------------------------x

AFFIDAVIT OF OWNERSHIP
I, _____________________________, of legal age, Filipino, widow and a
resident of ____________________________ having been duly sworn in
accordance with law, hereby depose and state:
1. That I am a bonafide resident of _____________________;
2. That I am the heir of the late _________________ whom, during his
lifetime, was the survey claimant of property identified as
________________________ situated in ___________________;
3. That since time immemorial, I am the one who is in continuous, peaceful,
material and actual possession of the subject property
_____________________, and it is a common knowledge in our
community / barangay that I own the subject property being the longtime
and actual occupant thereto;
4. That I am executing this Affidavit to attest to the truthfulness of the
foregoing facts, for all legal intent and purposes.
IN WITNESS WHEREOF, I have hereunto set my hand this
_______________ at Roxas City, Capiz.

________________________
Affiant
SUBSCRIBED AND SWORN to before me this _____________ at Roxas
City, Capiz, Philippines by affiant who is personally known to me and further
exhibited her competent identity as shown above.