REPUBLIC OF THE PHILIPPINES)

ZAMBOANGA CITY ) S.S.

AFFIDAVIT OF SELF-ADJUDICATION OF ESTATE

OF THE DECEASED PARENTS

I, JUAN S. DELA CRUZ, of legal age, Filipino citizen, single with residence at
Meteor Street, Silver Village, Zamboanga City, after having been sworn in accordance
with law, hereby depose and say:

1. That I am the only child and sole heir of the deceased LAURO F. DELA CRUZ and
LAURA S. DELA CRUZ, both of them died without any last will and testament on
March 22, 2008 and August 4, 2008, respectively, both in Zamboanga City as
evidenced by their respective Death Certificate issued by the Municipality of Cawa,
Zamboanga City hereto attached as Annexes “A” and “B”, respectively and made an
integral part of this Affidavit;

2. That at the time of their death, my father and my mother had no debts, liabilities or
obligations to any person, agency or institution;

3. That said decedents left the following real and personal properties, to wit:

Transfer Certificate of Title No. T-397125

“A parcel of land (Lot 1, Block 1 of the cons.-subd. plan Pcs-04-005657, being a

portion of the consolidation of Lots 4 & 5, Pcs-04-005566, Blk. 28, Pcs-04-005481,
Lot 1619-C, Psd-04-044478, Lot 1653, Sta. Clara , Estate, Lot 2208-B (LRC) Psd-
6835 & Lot 1670-New-B, Psd-04-041447, LRC Record No. ), situated in the Bo.
of Labi; Mun. of Sta. Clara, Province of Zamboanga. Bounded on the W., along
line 1-2-3 by Road Lot 1; on the N., along line 3-4 by Road Lot 75; on the E.,
along line 4-5 by Lot 1; on the S., along line 5-1 by Lot 21, Blk. 13, all f the
consolidation / subdivision plan. X x x x x x x containing an area of ONE
EIGHTY SEVEN (87) SQUARE METERS. Declared for taxation purposes under
Tax Dec. No. 270-01256 at market value of P15,660.00 and the improvement
thereon consisting of a residential house.”

(8) Certificates of Stock No. 001 and 002

“Certificates of Stock No. 001 and 002 with the Kainan sa Seaside, Inc. valued at
P33,200.00 (332 shares at P100.00) and P33,100.00 (331 shares at P100.00),
respectively or a total of P66,300.00.”

4. That pursuant to the provisions of Section 1, Rule 74 of the New Rules of Court, I
hereby adjudicate unto myself the above described properties, subject to the
liabilities imposed under Section 4 of the same Rule 74 of the New Rules of Court in
favor of any other possible heir or creditor who may have been unduly deprived of
their legal participation in the said estate and hereby requests the Registry of Deeds
for Zamboanga City and Kainan sa Seaside, Inc. to register and effect the transfer of
ownership thereto in my favor.
Affidavit of Self-Adjudication of Estate of the Late Florante M. Baldovino and Jesusa F. Baldovino 1
5. That the parcels of land above-described do not come under the operation of the
Comprehensive Agrarian Reform Law, as amended, the same being residential lots.

IN WITNESS WHEREOF, I have here unto set my hand this _____day of June,
2020 at ___________________

JUAN S. DELA CRUZ

Heir-Affiant

Signed in the Presence of:

Janina A. Delos Reyes Patricio A. Delos Reyes

Witness Witness

SUBSCRIBED and SWORN to before me, this _______day of June, 2020, at

Zamboanga City, affiant exhibiting to me his U.M.I.D. No. 0347-1234567-0 as proof of
identification.

NOTARY PUBLIC

Doc. No. ________;

Page No.________;
Book No.________;
Series of 2020.

Affidavit of Self-Adjudication of Estate of the Late Florante M. Baldovino and Jesusa F. Baldovino 2