REPUBLIC OF THE PHILIPPINES 

)
CITY OF TANAUAN                       : S.S.
PROVINCE OF BATANGAS          )

AFFIDAVIT OF SELF-ADJUDICATION OF THE

ESTATE OF DECEASED PERSON
 
            I, TERESA S. CACAO, single, of legal age, Filipino citizen and with residence and postal address
atPoblacion, Talisay, Batangas, after having been duly sworn an oath in accordance with law, hereby depose and
say:

            That I am the only surviving legal heir of my late grandfather MARIANO SORIANO who died intestate on
________________________ at Poblacion, Talisay, Batangas.

            That the said deceased left a parcel of agricultural land and more particularly described and bounded as
follows:

“A parcel of agricultural land situated at Brgy. Tumaway, Talisay, Batangas containing an area of Thirty
Thousand and Thirty Eight (30,038) Square Meters, more or less; bounded on the North by Guillermo Austria; on
the East by Barranco; on the South by Barranco; and on the West by Barranco; covered by Tax Declaration No. 28-
0024-00847 of the Assessor’s Office of Talisay, Batangas with an assessed value of  P120,500.00”

            That since the said deceased left no will or testament, I hereby adjudicate and by these presents
ADJUDICATE upon myself the above-described property pursuant to the provision of Rule 74, Section 1 of the
Rules of Court of the Philippines and hereby files the same with the request that said adjudication be made effective
without judicial proceeding as prescribed by the aforementioned Rules of Court.

            That I subscribed to this affidavit that I am the only surviving legal heir of my late grandfather Mariano

Soriano.

            IN WITNESS WHEREOF, I have hereunto set my hand, this _____ day of ______________, 2010 at City of
Tanauan, Batangas, Philippines.

                       
                                                                                             TERESA S. CACAO
                                                                                                        Affiant

SIGNED IN THE PRESENCE OF:

1. _____________________________                                        2. ____________________________

            SUBSCRIBED AND SWORN to before me, this ____day of ______________, 2010 at City of Tanauan,
Batangas, Philippines affiant exhibiting to me her Community Tax Certificate No. 16832466, issued at Talisay,
Batangas on May 4, 2010.

Doc. No. ___________

Page No. ___________
Book No. ___________
Series of 2010