REPUBLIC OF THE PHILIPPINES }

________________________ }s.s.
________________________

AFFIDAVIT OF INSERTION

I, __________________, of legal age, Filipino citizen, and with residence and postal address
at ________________________, after having been duly sworn in accordance with law, hereby
deposes and says:

1. That I have notarized a certain document Deed of Sale of Portion of Land dated June
08, 2017 executed by _________________________ in favor of
__________________ and entered in my Notarial Book as per Doc. No. ; Page No. ;
Book No. ; Series of . Copy of the same is hereto attached;

2. That there was an omission in entry in the said document particularly the name of spouse of
the vendee;

3. That I have inserted the said entry and countersigned the same, as follows:

a. _______________________, “married to ____________________”;

4. That I am executing this affidavit to attest to the truth of the foregoing instrument and for
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of _______, 2019 at
__________________.

_________________________

Affiant

SUBSCRIBED AND SWORN, to before me this ___ day of _______, 2019 at

________________ affiant exhibited to me his Roll of Attorney .

Doc No.: ________;

Page No.: ________; Notary Public
Book No.: ________;
Series of 2019.