REPUBLIC OF THE PHILIPPINES }
PROVINCE OF RIZAL }
MUNICIPALITY OF _____________ }S.S.
AFFIDAVIT OF APPLICANT FOR RESIDENTIAL FREE PATENT
I, _________________________________________________________ of legal age,
(Single/Married/Widow/Widower) Filipino, Citizen, and resident of
__________________________________________________ in accordance to law, herby and
voluntary depose and state;
That I am the holder of Residential Free Patent Application No.
_________________, for parcel of land described as Lot No. __________________
Cad No. _________________, situated at Barangay ________________
Municipality of ____________Province of Rizal, containing an area of
___________ square meters;
That I am the owner, actual possession and occupation of the
abovementioned parcel of land that I acquired my ownership thru
_____________________ since _________up to this present;
That the above-mentioned parcel of land is the only land that I
applied for Residential Free patent under Republic Act No. 10023 in the
Municipality of ______________________ Province of Rizal;
That I am hold myself solely responsible for any liability, whether civil
and criminal that arises if the corresponding Certificate of Title had it in fact
been issued and for any statement;
That I executed this affidavit in support to my residential free patent
application freely, voluntarily and fully understand the contents hereof.
IN WITNESS WHEREOF, I have hereunto signed my name this _____ day of
_________________, 2022 at _________________________.
_______________________________
Applicant’s Name and Signature
SUBSCRIBED AND SWORN TO BEFORE ME this _____ day of
______________, 2022, at ________________________________________ affiant exhibited
to me his/her CTC/ID No. _______________ issued on _______________ at
_____________________.
_________________________
Officer Authorized to
Administer Oath