REPUBLIC 

OF THE PHILIPPINES)
                     ) S.S.
x------------------------------------------x
  
AFFIDAVIT OF SELF-ADJUDICATION WITH SALE

         I, ZENAIDA C. VILA, widow, Filipino citizen, of legal age, and a resident of 320 Sevilla
Compound Masaluhat I Candelaria, Quezon, after having been duly sworn to in accordance
with law, depose and state:

1. That I am the sole surviving heir of my spouse CRISPIN V. VILA who died without
any last will and testament on 2021 in Atimonan, Quezon; 

2. That when my spouse died, he left a certain motorcycle with sidecar (No. 339) and
with Franchise to Operate a Public Utility Tricycle under Franchise No. 2021-
ATRB-0339 valid until February 2022 (Atimonan Quezon), which is more
particularly described as follows: 
 
MAKE                   : KAWASAKI PLATE NO : NEW
MODEL             : CT 125
ENGINE NO   : DYXWLH16969
CHASSIS NO    : MD2A76BX6LWH64124

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

4. That pursuant to Rule 74, Sec. 1 of the Rules of Court, I hereby adjudicate unto
myself the above-described motor vehicle by means of this Affidavit  with the request
that the said adjudication be made effective without judicial proceeding as prescribed
by the aforementioned provision of the Rules of Court thereby consolidating full
ownership of the said motor vehicle. This affidavit of self-adjudication supersedes
whatever document I may have previously executed and renders it to be without any
force and effect.

5. That for and in consideration of the sum of ONE HUNDRED THOUSAND

PESOS (Php 100,000.00), Philippine Currency, receipt whereof is hereby
acknowledged to my entire satisfaction, I hereby sell, transfer and convey by way
of Absolute Sale to LOURDES ARCHETA AMBAS, Filipino, of legal age, and
resident of Brgy.Malusak Atimonan, Quezon, the above-described motor
vehicle, free from all liens and encumbrances. All expenses related to the sale of
the above-mentioned vehicle shall be for the account of the vendee.

Affiant further sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of November
2021 in _________________________________, Philippines.
          

LOURDES ARCHETA AMBAS ZENAIDA C. VILA

Vendee                                 Affiant/ Vendor

Signed in the presence of: 

_____________________________                 ______________________________
 

1
 ACKNOWLEDGEMENT
 
Republic of the Philippines )
                                    ) S.S
 
BEFORE ME, this ___ day of ______________ 2021, in
________________________personally appeared:

ZENAIDA C. VILA
LOURDES ARCHETA AMBAS

Known to me and to me known to be the same persons who executed the foregoing
instrument, consisting of two (2) pages, including the page on which this acknowledgment is
written has been signed by the affiant and witnesses and acknowledged to me that the
same is their free and voluntary act and deed.
 
WITNESS MY HAND AND SEAL, on the date and place first above written.
                                                                  
                                                                              
       Notary Public

Doc. No.______;
Page No. ______;
Book No.______;
Series of 2021.