REPUBLIC OF THE 

PHILIPPINES)
CITY OF DIPOLOG                     ) S.S.
x-------------------------------------x
  

AFFIDAVIT OF SELF-ADJUDICATION

         I, CHRISTIAN C. DELA CRUZ, of legal age, Filipino, single and a resident
of 6789 Seven/Evelyn Street, Sta. Isabel, Dipolog City, after having been
duly sworn to in accordance with law, depose and state:

1. That I am the only son of JUAN B. DELA CRUZ who died without any last will
and testament on July 20, 2020 in Dipolog City as evidenced by his Death
Certificate issued by the City of Dipolog hereto attached as Annex “A” and
made an integral part of this Affidavit; 

2. That at the time his death, my father had no debts, liabilities or obligations
to any persons, agency or institution;

3. That the only property he left is a parcel of land consisting of 60 square

meters located in Katipunan Street, Dipolog City more particularly
described in TCT No. 112233 hereto attached as Annex “B” and made an
integral part of this Affidavit;

4. That pursuant to Rule 74, Sec. 1 of the Rules of Court, I hereby adjudicate

unto myself the above-described real estate by means of this Affidavit and
hereby files the same with the Register of Deed of Dipolog City with the
request that the said adjudication be made effective without judicial
proceeding as prescribed by the aforementioned provision of the Rules of
Court.
         IN WITNESS WHEREOF, I have hereunto set my hand this 21st day
of September 2020 in Dipolog City, Philippines.
          
CHRISTIAN C. DELA CRUZ

Affiant

    SUBCRIBED AND SWORN TO before me this 26th day of September

2020 in Dipolog City, Philippines, affiant exhibiting to me her Philippine
Passport No. 123456 issued in Manila on January 12, 2018 and valid
until January 12, 2028.

Doc. No. 69;

Page No. 88;
Book No. 69;
Series of 2020.