Republic of the Philippines)

Municipality of Sibulan. . . ) S. S.
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AFFIDAVIT OF HEIRSHIP AND UNDERTAKING WITH CONSENT

I, LEVY F. CALINTIG, married, of legal age, Filipino, and resident of

Calabnugan, Sibulan, Negros Oriental, after having been duly sworn to in
accordance with law, hereby state and declare that:

1. I am one of the surviving heirs of the late BENITA UMBAC, who

died intestate and left no known debts that remains unpaid, who is the
registered co-owner of a parcel of land known as Lot No. 750 of the Cadastral
Survey of Sibulan, containing an area of SEVEN THOUSAND ONE HUNDRED
SIXTY SIX (7, 166) situated in Municipality of Sibulan, Negros Oriental
and covered by Original Certificate of Title No.O-V-9538;

2. That the late BENITA UMBAC died intestate and left no debts or
obligations due against her estate and was survived by her eight (8) children,
one of which is HERMINIA UMBAC PIŇERO, who is my mother;

3. That the late HERMINIA UMBAC PIŇERO died intestate and left
no debts or obligations due against her estate and was survived by her nine (9)
children, I am one of them;

4. With the death of my parents and grandparents, I am entitled to

inherit and/or succeed to the abovedescribed parcel of land through
succession;

5. I am giving consent to ANGELICA FORTUITO ZERNA for her to

apply for a Building Permit to the Office of the Local Building Official for the
construction of her residential building on the said lot. I further undertake
that the department/person/agency/ approving the said permit is not to be
made accountable relative to its issuance and I take full responsibility in case
of any claims or complaints including the application of building permit on the
abovementioned lot being one of the heirs of the registered owners thereon;

6. I am executing this affidavit in order to establish all of the foregoing

facts, and in order to establish that I am one of the surviving heirs of the late
BENITA UMBAC, entitled to inherit to the aforementioned parcel of land;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 28 th

day of October 2020 in Sibulan, Negros Oriental, Philippines.

LEVY F. CALINTIG
AFFIANT
COMELEC ID with VIB: 4620-0040B-L2372LFC20000

SUBSCRIBED AND SWORN TO BEFORE ME, this 28TH day of October,

2020 in Sibulan, Negros Oriental, Philippines, affiant exhibited to me proof of
her identity written below her respective name and signature.

Doc. No. 170;

Page No. 35;
Book No. II;
Series of 2020.