Affidavit
Affidavit
Affidavit
28-11 (R)
AFFIDAVIT
That I am only the claimant of the afore-cited lot during the survey;
That the land is agricultural and not tenanted and I am in actual occupation and
cultivation of the same;
That the said lot is NOT pending hearing in the court under L.R.C./G.L.R.C. Cad-
Record No. N/A and I recognize the same as public land. In the meantime, I will
proceed with my Free Patent Application No. __________;
That I hold myself solely responsible for any liability, whether civil and/or criminal
that may arise if the land has already been adjudicated as private property and/or the
corresponding title had in fact been issued, and for my statement I have made herein
that may be found untrue or false;
That I am a natural born citizen of the Philippines and not the owner of more than
twelve (12) hectares of land in the Philippines; and
That I execute this Affidavit freely and voluntary and fully understand the
contents hereof.
__________________________
Applicant/Affiant
__________________________
Special Land Investigator/
Land Management Inspector/
Deputized Land Mgt. Inspector
SRC\macky\form\affidavit.doc