AFFIDAVIT OF SELF AJUDICATION OF THE ESTATE OF THE

LATE ROLANDO EUGENIO PARCON

KNOW ALL MEN BY THESE PRESENTS:

That I am ELAINE PARCON- WILSHIRE, of legal age, Filipino, with

residence at Putik-Tumaga Road, Zamboanga City, hereby freely and
spontaneously- -

DECLARE AND MAKE MANIFEST:

1. That I am the sister and the only heir who survived the deceased
ROLANDO EUGENIO PARCON;

2. That the aforementioned decedent died at Zamboanga City on January

28, 2001;

3. That the deceased, ROLANDO EUGENIO PARCON, died intestate, without

Will or Testament, and without any outstanding debts in favor of any
person or entity;

4. That the deceased, at time of his death left parcel of Burial Lots with the
GOLDEN HAVEN MEMORIAL PARK.
5. That I am adjudicating unto myself the aforesaid parcel of burial lots.
IN WITNESS WHEREOF, I have hereunto affixed my signature this __ th
day of ___________ 2022 at Zamboanga City, Philippines.

ELAINE PARCON- WILSHIRE

Affiant
Phil. Passport No. P9739449A

Issued/Valid Until: Zamboanga City/Nov. 27, 2028

SIGNED IN THE PRESENCE OF:

______________________________ & _________________________________

Republic of the Philippines )

City of Zamboanga ) S.S
 x-------------------------------------------x

ACKNOWLEDGEMENT

            BEFORE ME, A NOTARY PUBLIC for and in the City of Zamboanga,
Philippines, this __th day of _______, 2022 personally appeared the above-
named person, exhibiting to me her respective Identification Card bearing
numbers as above-written. Known to me and to me Known to be the same
person who executed the foregoing document, and acknowledged to me that
same is her voluntary act and deed;

WITNESS MY HAND AND SEAL, on the date and place first above written.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

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