Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFEREES
We, JACINTO G. REALISTA, ISIDORO G. REALISTA, VICTORIANO G. REALISTA, JR., and
ANTONIETTA REALISTA-PE AGUIRRE, all Filipinos, of legal ages, all married and residents of
Poblacion, Baclayon, Bohol, Philippines, after being duly sworn to in accordance with law, herby
depose and say:
1. That we are the Transferees of parcels of land which are more particularly described and
bounded in “ANNEX A” hereof;
2. That we do not own agricultural lands in excess of the landholdings allowed by law
including the parcels of land mentioned in annex “A” which will be transferred to us;
3. That we given notice to the Barangay Agrarian Reform Council of the barangay where
the land is situated regarding the partition and also the fact that our total landholdings
do not exceed the landholding ceiling as provided in R.A. 6657;
4. That we are executing this affidavit voluntarily in compliance with the requirements of
R.A. 6657 and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989
and to request the Provincial Agrarian Officer and the Register of Deeds of Bohol for a
favourable action on the Extrajudicial Settlement of Estate of Deceased Persons and
Partition of registered parcels of land in our favour.
IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
________________________ at the City of Tagbilaran, Philippines.
JACINTO G. REALISTA ISIDORO G. REALISTA
Affiant Affiant
VICTORIANO G. REALISTA, JR. ANTONIETTA REALISTA-PE AGUIRRE
Affiant Affiant
SUBSCRIBED AND SWORN to before me this ________ day of
_______________________ at the City of Tagbilaran, Philippines, by the affiant:
Name CTC/ID No. Date and Place Issued
JACINTO G. REALISTA ____________ ________________________________
ISIDORO G. REALISTA ____________ ______________________________
VICTORIANO G. REALISTA, JR. ____________ ______________________________
ANTONIETTA REALISTA-PE AGUIRRE ____________ ______________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2014.
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFERORS
We, JACINTO G. REALISTA, ISIDORO G. REALISTA, VICTORIANO G. REALISTA, JR., and
ANTONIETTA REALISTA-PE AGUIRRE, all Filipinos, of legal ages, all married and residents of
Poblacion, Baclayon, Bohol, Philippines, after being duly sworn to in accordance with law, herby
depose and say:
1. That we are the Transferors of parcels of land which are more particularly described and
bounded in “ANNEX A” hereof;
2. That the total aggregate area of all our agricultural lands in the Philippines including
conjugal properties with our respective spouses, including the lands subject of the
stated transaction, is less than five (5) hectares;
3. That the lands herein transferred are within the retention limit pursuant to Section 6,
R.A. 6657;
4. That this affidavit is executed to attest to the truth and veracity of the foregoing facts
and for whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
________________________ at the City of Tagbilaran, Philippines.
JACINTO G. REALISTA ISIDORO G. REALISTA
Affiant Affiant
VICTORIANO G. REALISTA, JR. ANTONIETTA REALISTA-PE AGUIRRE
Affiant Affiant
SUBSCRIBED AND SWORN to before me this ________ day of
_______________________ at the City of Tagbilaran, Philippines, by the affiant:
Name CTC/ID No. Date and Place Issued
JACINTO G. REALISTA ____________ ________________________________
ISIDORO G. REALISTA ____________ ______________________________
VICTORIANO G. REALISTA, JR. ____________ ______________________________
ANTONIETTA REALISTA-PE AGUIRRE ____________ ______________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2014.
Republic of the Philippines)
____________________) S.S.
AFFIDAVIT OF TRANSFEREE
I, MARY THERESE DIANE REALISTA BARRUN, Filipino, of legal age, married to Joram Magallanes
Barrun and a resident of Aluba Village Subdivision, Phase I, Quezon St., Mandumol, Macasandig,
Cagayan de Oro City, Philippines, after being duly sworn to in accordance with law, herby depose and
say:
1. That I am the Transferee of a parcel of land which is more particularly described and bounded as
follows, to wit:
ORIGINAL CERTIFICATE OF THE TITLE NO. 14957
(Lot No. 574, Cad-342-D)
‘’A parcel of land (Lot No. 574, Cad-342-D)situated in the Barrio of Quezon, Municipality
of Batuan, Province of Bohol, Island of Bohol, Bounded on the N., along lines 1-2-3-4-5-6-7-8 by
Lot No. 573, Cad-342-D; on the NE., along line 8-9 by Lot No. 331, Cad-342-D; on the E., along
line 9-10-11 by Lot 329, Cad-342-D; on the SE., along line 11-12 by Lot No. 575, Cad-342-D; on
the S., along lines 12-13-14-15 by Lot No. 568, Cad-342-D; and on the SW., along lines 15-16-17-
18-19-20-21 by Lot No. 569, Cad-342-D; on the NW., along lines 21-22-23-1 by Lot No. 571, Cad-
342-D. Containing an area of TWENTY THREE THOUSAND EIGHT HUNDRED AND SEVENTY
(23,870) Square Meters, more or less.”
2. That I and my husband do not own agricultural lands in excess of the landholdings allowed by
law including the above-described parcel of land which will be transferred to my name;
3. That I given notice to the Barangay Agrarian Reform Council of the barangay where the land is
situated regarding the sale and also the fact that our total landholdings do not exceed the
landholding ceiling as provided in R.A. 6657;
4. That I am executing this affidavit voluntarily in compliance with the requirements of R.A. 6657
and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989 and to request the
Provincial Agrarian Officer and the Register of Deeds of Bohol for a favourable action on the
Extrajudicial Settlement of Estate Among Heirs with Partition and Simultaneous Sale of a Parcel
of Land of registered parcel of land in my favour.
IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of
________________________ at ________________________, Philippines.
MARY THERESE DIANE REALISTA BARRUN
Affiant
Signed in the presence of: _____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of _______________________ at
________________________, Philippines, by the affiant with her
_____________________________________________________.
Doc. No. _______; Page No. _______;
Book No. _______; Series of 2015.
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFEREES
We, ANTERO MAGELLAN S. GABLINES and MARIA JANET R. SANGUENZA, Filipinos, of legal
ages, married to each other and residents of Bingag, Dauis, Bohol, Philippines, after being duly
sworn to in accordance with law, herby depose and say:
1. That we are the Transferees of a certain parcel of an agricultural land situated at Cuasi,
Loon, Bohol, Philippines, designated as Lot 3076, containing an area of Two Thousand
Four Hundred Eighty Four (2,484) Square Meters, more or less, described in and covered
by Katibayan ng Orihinal na Titulo Blg. 118249 of the Registry of Deeds for the Province
of Bohol;
2. That we do not own agricultural lands in excess of the landholdings allowed by law including the
above-described parcel of land which will be transferred to our names;
3. That we given notice to the Barangay Agrarian Reform Council of the barangay where the land is
situated regarding the sale and also the fact that our total landholdings do not exceed the
landholding ceiling as provided in R.A. 6657;
4. That we are executing this affidavit voluntarily in compliance with the requirements of R.A. 6657
and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989 and to request the
Provincial Agrarian Officer and the Register of Deeds of Bohol for a favorable action on the
Extrajudicial Settlement with Simultaneous Sale of registered parcel of land in our favour.
IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
________________________ at Tagbilaran City, Philippines.
ANTERO MAGELLAN S. GABLINES MARIA JANET R. SANGUENZA
Affiant Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of
_______________________ at the City of Tagbilaran, Philippines, by the affiant:
Names CTC/ID Nos. Issued on/in/by
ANTERO MAGELLAN S. GABLINES ______________ ________________________________
MARIA JANET R. SANGUENZA ______________ ________________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2015.
______________________________
BARC Chairman
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFERORS
We, EULOGIA L. MARSAMOLO, Filipino, of legal age, widow and a resident of Loon, Bohol,
Philippines, FE L TOMACLAS, Filipino, of legal age, married and a resident of Loon, Bohol, Philippines,
represented herein by her brother, HONORATO C. LESONDRA, by virtue of a Special Power of Attorney
dated June 20, 2015, duly acknowledged before a Notary Public, Atty. Heneth C. Napigquit-Baje, as per
Doc. No. 1,808, Page No. 102, Book No. 154, and Series of 2015, EGNACIA L. COLYADA, Filipino, of legal
age, widow and a resident of Loon, Bohol, Philippines, represented herein by her brother, HONORATO
C. LESONDRA, by virtue of a Special Power of Attorney dated June 20, 2015, duly acknowledged before a
Notary Public, Atty. Heneth C. Napigquit-Baje, as per Doc. No. 1,808, Page No. 102, Book No. 154, and
Series of 2015, and HONORATO C. LESONDRA, Filipino, of legal age, married and a resident of Loon,
Bohol, Philippines, after being duly sworn to in accordance with law, herby depose and say:
1. That we are the Transferors of a certain parcel of an agricultural land situated at Cuasi, Loon,
Bohol, Philippines, designated as Lot 3076, containing an area of Two Thousand Four Hundred
Eighty Four (2,484) Square Meters, more or less, described in and covered by Katibayan ng
Orihinal na Titulo Blg. 118249 of the Registry of Deeds for the Province of Bohol;
2. That the total aggregate area of all our agricultural lands in the Philippines, including the land
subject of the stated transaction, is less than five (5) hectares;
3. That the land herein transferred is within the retention limit pursuant to Section 6, R.A. 6657;
4. That this affidavit are executed to attest to the truth and veracity of the foregoing facts and for
whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto set our hand this ______ day of
________________________ at the City of Tagbilaran, Philippines.
EULOGIA L. MARSAMOLO HONORATO C. LESONDRA
Affiant (FOR: HIMSELF and FE L TOMACLAS
EGNACIA L. COLYADA)
Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of _______________________ at the
City of Tagbilaran, Philippines, by the affiant:
Names CTC/ID Nos. Issued on/in/by
EULOGIA L. MARSAMOLO ______________ ________________________________
HONORATO C. LESONDRA ______________ ______________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2015.
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFERORS
We, GERTRUDES S. MANLUPIG, Filipino, of legal age, married and a resident of Taloto District,
Tagbilaran City, Philippines, BENITA MANLUPIG CARCASONA, Filipino, of legal age, married to Valerio
Carcasona and a resident of Taloto District, Tagbilaran City, Philippines, and ZOSIMO S. MANLUPIG,
Filipino, of legal age, married to Fe Pusta and a resident of Taloto District, Tagbilaran City, Philippines,
1. That we are the Transferors of two (2) portions of an agricultural land situated in Anislag,
Corella, Bohol, Philippines, designated as Lot No. 12316-C, containing an area One Hundred Fifty
Seven (157) Square Meters, more or less, and Lot No. 12316-D, containing an area Three
Hundred Fourteen (314) Square Meters, more or less, which portions forms part of the
whole parcel of land situated in Anislag, Corella, Bohol, Philippines, designated as Lot No. 12316
situated in Anislag, Corella, Bohol, Philippines, designated as Lot No. 12316 containing an area of
Nine Hundred and Four (904), described in and covered by Katibayan ng Orihinal na Titulo Blg.
104619.
2. That the total aggregate area of all our agricultural lands in the Philippines, including the land
subject of the stated transaction, is less than five (5) hectares;
3. That the land herein transferred is within the retention limit pursuant to Section 6, R.A. 6657;
4. That this affidavit is executed to attest to the truth and veracity of the foregoing facts and for
whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto set our hand this ______ day of
________________________ at the City of Tagbilaran, Philippines.
GERTRUDES S. MANLUPIG BENITA MANLUPIG CARCASONA
Affiant Affiant
ZOSIMO S. MANLUPIG
Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of _______________________ at the
City of Tagbilaran, Philippines, by the affiant:
Names CTC/ID Nos. Issued on/in/by
GERTRUDES S. MANLUPIG ______________ ________________________________
BENITA MANLUPIG CARCASONA ______________ ______________________________
ZOSIMO S. MANLUPIG ______________ ______________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2015.
AFFIDAVIT OF TRANSFEREES
We, Spouses RANEL D. SULIANO and MARCH D. LUPIAN, Filipinos, of legal ages, married to
each other and residents of Dao District, Tagbilaran City, Philippines, after being duly sworn to
in accordance with law, herby depose and say:
1. That we are the Transferees of a portion of an agricultural land situated in Anislag, Corella,
Bohol, Philippines, designated as Lot No. 12316-C, containing an area One Hundred Fifty Seven
(157) Square Meters, more or less, which portion forms part of the whole parcel of land situated
in Anislag, Corella, Bohol, Philippines, designated as Lot No. 12316 situated in Anislag, Corella,
Bohol, Philippines, designated as Lot No. 12316 containing an area of Nine Hundred and Four
(904), described in and covered by Katibayan ng Orihinal na Titulo Blg. 104619;
2. That we do not own agricultural lands in excess of the landholdings allowed by law including the
above-described parcel of land which will be transferred to our names;
3. That we given notice to the Barangay Agrarian Reform Council of the barangay where the land is
situated regarding the sale and also the fact that our total landholdings do not exceed the
landholding ceiling as provided in R.A. 6657;
4. That we are executing this affidavit voluntarily in compliance with the requirements of R.A. 6657
and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989 and to request the
Provincial Agrarian Officer and the Register of Deeds of Bohol for a favorable action on the
Extrajudicial Settlement with Simultaneous Sale of Portions of registered parcel of land in our
favour.
IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
________________________ at Tagbilaran City, Philippines.
RANEL D. SULIANO MARCH D. LUPIAN
Affiant Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of
_______________________ at the City of Tagbilaran, Philippines, by the affiant:
Names CTC/ID Nos. Issued on/in/by
RANEL D. SULIANO ______________ ________________________________
MARCH D. LUPIAN ______________ ________________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2016.
AFFIDAVIT OF TRANSFEREES
We, Spouses NONITO PAUNAT and DOLORES MANLUPIG, Filipinos, of legal ages, married to
each other and residents of Taloto District, Tagbilaran City, Philippines, after being duly sworn
to in accordance with law, herby depose and say:
1. That we are the Transferees of a portion of an agricultural land situated in Anislag, Corella,
Bohol, Philippines, designated as Lot No. 12316-D, containing an area Three Hundred
Fourteen (314) Square Meters, more or less, which portion forms part of the whole parcel of
land situated in Anislag, Corella, Bohol, Philippines, designated as Lot No. 12316 situated in
Anislag, Corella, Bohol, Philippines, designated as Lot No. 12316 containing an area of Nine
Hundred and Four (904), described in and covered by Katibayan ng Orihinal na Titulo Blg.
104619;
2. That we do not own agricultural lands in excess of the landholdings allowed by law including the
above-described parcel of land which will be transferred to our names;
3. That we given notice to the Barangay Agrarian Reform Council of the barangay where the land is
situated regarding the sale and also the fact that our total landholdings do not exceed the
landholding ceiling as provided in R.A. 6657;
4. That we are executing this affidavit voluntarily in compliance with the requirements of R.A. 6657
and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989 and to request the
Provincial Agrarian Officer and the Register of Deeds of Bohol for a favorable action on the
Extrajudicial Settlement with Simultaneous Sale of Portions of registered parcel of land in our
favour.
IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
________________________ at Tagbilaran City, Philippines.
NONITO PAUNAT DOLORES MANLUPIG
Affiant Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of
_______________________ at the City of Tagbilaran, Philippines, by the affiant:
Names CTC/ID Nos. Issued on/in/by
NONITO PAUNAT ______________ ________________________________
DOLORES MANLUPIG ______________ ________________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2015.
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFEREES
We, Spouses ALBERTO F. ALAS and LAURA U. ALAS, Filipinos, of legal ages, married to each other
and residents of San Roque, Baclayon, Bohol, Philippines, after being duly sworn to in accordance with
law, herby depose and say:
1. That we are the Transferees of a portion of a certain parcel of an agricultural land situated at
San Roque, Bohol, Philippines, designated as Lot 329-A, containing an area of SIX HUNDRED
FORTY THREE (643) Square Meters, more or less, which portions forms part of a whole parcel of
land situated at San Roque, Bohol, Philippines, designated as Lot 329, containing an area of ONE
THOUSAND FOUR HUNDRED FORTY NINE (1,449) Square Meters, more or less, described in and
covered by Original Certificate of No. 52430, of the Registry of Deeds for the Province of Bohol;
2. That we do not own agricultural lands in excess of the landholdings allowed by law including the
above-described parcel of land which will be transferred to our names;
3. That we given notice to the Barangay Agrarian Reform Council of the barangay where the land is
situated regarding the sale and also the fact that our total landholdings do not exceed the
landholding ceiling as provided in R.A. 6657;
4. That we are executing this affidavit voluntarily in compliance with the requirements of R.A. 6657
and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989 and to request the
Provincial Agrarian Officer and the Register of Deeds of Bohol for a favorable action on the
Extrajudicial Settlement with Simultaneous Sale of registered parcel of land in our favour.
IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of
________________________ at Tagbilaran City, Philippines.
ALBERTO F. ALAS LAURA U. ALAS
Affiant Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of _______________________ at the
City of Tagbilaran, Philippines, by the affiant:
Names CTC/ID Nos. Issued on/in/by
ALBERTO F. ALAS ______________ _____________________________________
LAURA U. ALAS ______________ ____________________________________
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2016.
_____________________________
BARC Chairman
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFERORS
We, NILDA JAYAG GINETE, Filipino, of legal age, widow and a resident of San Roque, Baclayon,
Bohol, Philippines, CARLO J. GINETE, Filipino, of legal age, married and a resident of San Roque,
Baclayon, Bohol, Philippines, KARINA GINETE NARANJO, Filipino, of legal age, married and a resident of
San Roque, Baclayon, Bohol, Philippines,
1. That we are the Transferors of a certain parcel of an agricultural land which is more
particularly described and bounded as follows:
Katibayan ng Irihinal na Titulo blg. 71543
“A parcel of land (Lot No. 2650-F, Csd-071205-004620, Iden. to lot No. 10076; CAD 359-D.)
situated in the Barrio of Landican, Municipality of Baclayon, Province of Bohol, Island of Bohol. Bounded
on the E., along line 1-2 by Lot No. 2650-E., Csd-071205-004620; on the SE., along line 2-3 by Provincial
Road (15.00 m. wide); on the SW., along lines 3-4-5 by lot No. 2642; on corner 5 by lot No. 2651; on the
NW., along line 5-6 by lot No. 2642; on the N., along line 6-1 by lot No. 2650-C, Csd-071205-004620; all
of CAD 359-D. Containing an area of ONE THOUSAND ONE HUNDRED THIRTY TWO (1,132) SQUARE
METERS, more or less.”
2. That the total aggregate area of all our agricultural lands in the Philippines, including the land
subject of the stated transaction, is less than five (5) hectares;
3. That the land herein transferred is within the retention limit pursuant to Section 6, R.A. 6657;
4. That this affidavit are executed to attest to the truth and veracity of the foregoing facts and
for whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto set our hand this ______ day of
________________________ at the City of Tagbilaran, Philippines.
NILDA JAYAG GINETE CARLO J. GINETE
Affiant Affiant
KARINA GINETE NARANJO
Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of _______________________ at the
City of Tagbilaran, Philippines, by the affiant:
Name TIN/ID No. Issued on/by/in
NILDA JAYAG GINETE _____________ ________________________________
CARLO J. GINETE ____________ ______________________________
KARINA GINETE NARANJO _____________ ________________________________
Doc. No. _______; Page No. _______;
Book No. _______; Series of ________.
Republic of the Philippines)
City of Tagbilaran ) S.S.
AFFIDAVIT OF TRANSFEREE
I, RUFIL Y. JAYAG, Filipino, of legal age, married to Susan M. Nieves and a resident of San
Roque, Baclayon, Bohol, Philippines, after being duly sworn to in accordance with law, herby
depose and say:
1. That I am the Transferee of a certain parcel of an agricultural land which is more
particularly described and bounded as follows:
Katibayan ng Irihinal na Titulo blg. 71543
“A parcel of land (Lot No. 2650-F, Csd-071205-004620, Iden. to lot No. 10076; CAD 359-D.)
situated in the Barrio of Landican, Municipality of Baclayon, Province of Bohol, Island of Bohol. Bounded
on the E., along line 1-2 by Lot No. 2650-E., Csd-071205-004620; on the SE., along line 2-3 by Provincial
Road (15.00 m. wide); on the SW., along lines 3-4-5 by lot No. 2642; on corner 5 by lot No. 2651; on the
NW., along line 5-6 by lot No. 2642; on the N., along line 6-1 by lot No. 2650-C, Csd-071205-004620; all
of CAD 359-D. Containing an area of ONE THOUSAND ONE HUNDRED THIRTY TWO (1,132) SQUARE
METERS, more or less.”
2. That I and my wife do not own agricultural lands in excess of the landholdings allowed by law
including the above-described parcel of land which will be transferred to my name;
3. That I have given notice to the Barangay Agrarian Reform Council of the barangay where the
land is situated regarding the sale and also the fact that our total landholdings do not exceed the
landholding ceiling as provided in R.A. 6657;
4. That I am executing this affidavit voluntarily in compliance with the requirements of R.A. 6657
and DAR Administration Order No. 1, Series of 1989 dated January 3, 1989 and to request the Provincial
Agrarian Officer and the Register of Deeds of Bohol for a favorable action on the Extrajudicial Settlement
of Estate Among Heirs with Simultaneous Sale of registered parcel of land in my favor.
IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of
________________________ at Tagbilaran City, Philippines.
RUFIL Y. JAYAG
Affiant
Signed in the presence of:
_____________________ _______________________
SUBSCRIBED AND SWORN to before me this ________ day of
_______________________ at the City of Tagbilaran, Philippines, by the affiant with his Driver’s
License No. _______________ expires on __________________ and issued by the Land
Transportation Office (LTO)
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2016.