REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) S.S

CITY OF SAN FERNANDO )
x---------------------x

AFFIDAVIT OF SELF-ADJUDICATION BY A SOLE

HEIR OF ESTATE OF
A DECEASED PERSON WITH SALE

I, ROMO F. MAZON of legal age, married to Wilma Mazon, a Filipino

citizen and a resident of Brgy. Nazareno, Agoo, La Union, after having been
duly sworn in accordance with law, do hereby depose and state:

1.That I am the only surviving heir of my late CLAUDIO FORTES, who

died intestate on November 25,1964 at Agoo, La Union without living any
indebtedness.

2. That at the time of his death, he left a parcel of land in Brgy.

Nazareno, Agoo, La Union covered by Tax Declaration No.2009-01-
0012000996, containing an area of Two thousand one hundred forty nine
(2,149) square meters, more or less, particularly described to wit:

TAX DECLARATION NO. 2009-01-0012000996

“A parcel of land classified as Sugarland with an area of Two

Thousand one hundred fourty nine (2,149) square meters more or
less, located at Brgy. Nazareno, Agoo, La Union. Bounded on the North by
Lot No. SEC 009; on the East by Lot No. 11; on the South by Lot No. 03;
and on the West by Lot No. 01; designated with Cadastral Lot No. 13573
declared under Tax Declaration No. 2009-01-0012000996”

3. That pursuant to Article 74, Section 1 of the Rules of Court, I, being the sole
heir of the said deceased, hereby adjudicate unto myself the above-described
property by means of this affidavit and hereby file the same with Office of the
Registry of Deeds of La Union, with the request that the said adjudication be
made effective without judicial proceedings as prescribed by the
aforementioned provision of the Rules of Court.

DEED OF ABSOLUTE SALE

4. That I do hereby SELL, CEDE, TRANSFER and CONVEY the above-

described parcel of land unto and in favor of LEA MILANES GANADEN, of legal
age, single and a resident of Brgy. Nazareno, Agoo, La Union, his heirs and
assigns, free from all liens and encumbrances whatsoever, for and in
consideration of the amount of Fifty thousand pesos (Php. 50,000) only,
Philippine Currency, in hand paid to me by the latter.
 5. That I am executing this Affidavit to attest the veracity of the foregoing
facts and for whatever legal purpose or intent this may serve best.

IN WITNESS WHEREOF, we have hereunto set our hands this ______

day of _______at San Fernando City, La Union.

ROMO F. MASON LEA M. GANADEN

Affiant/Vendor Conforme /Vendee
Id No.____________ Id No._____________

SIGNED IN THE PRESENCE OF;

_________________________ _________________________

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) S.S
CITY OF SAN FERNANDO )
x---------------------x

BEFORE ME, appeared the above-named heirs/vendor this _____ day of

____, at San Fernando City, La Union, and Known to me to be the same
persons who executed the foregoing instrument and acknowledged the same is
their voluntary act and will.

This instrument consisting of two (2) pages which this acknowledgement

is written refers to an AFFIDAVIT OF SELF ADJUDICATION BY A SOLE HEIR
OF ESTATE WITH SALE has been signed by the heirs/vendor and the
witnesses on each and every page thereof and sealed with my notarial seal.

DOC No._____
PAGE No.____
BOOK No.____
SERIES OF 2022
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF LA UNION ) S.S
CITY OF SAN FERNANDO )
x---------------------x

AFFIDAVIT OF NON-TENANCY, NON IMPROVEMENTS,

AND TOTAL LAND HOLDINGS

That I, ROMO F. MAZON, married to Wilma Mazon, of legal age, and a

resident of Brgy. Nazareno, Agoo, La Union, after having been duly sworn to in
accordance with law, hereby deposes, and says;

That I am the only surviving heirs of the late CLAUDIO FORTES who is
the owner of a parcel of land (Sugarland), located at Brgy. Nazareno. Agoo, La
Union.
With an area of Two thousand one hundred fourty nine (2,149) square meters,
more or less, with Cadastral Lot No. 13573 declared under Tax Declaration No.
2009-01-0012-00996;

That the said property is now subject of a Affidavit of Self Adjudication by

a Sole Heir of Estate with sale in favor of LEA MILANES GANADEN;

That the said parcel is not tenanted and has/have no improvements

found thereon.

That the total landholdings of the late CLAUDIO FORTES does not
exceed limit prescribed by law;

That we are executing this affidavit to attest to the truth of the foregoing
facts. And for all legal intents and purposes;

IN WITNESS WHEREOF, we have hereunto set our hands this ________

day of ________, 2022 at San Fernando City, La Union.

ROMO F. MASON
Affiant

SUBSCRIBED AND SWORN to before me this ______ day of __________

2022 at San Fernando City La Union.

DOC No. _____

PAGE No. _____
BOOK No. _____
SERIES OF 2022