AFFIDAVIT

That we, REGINA ALCANTARA PELEGRIN, and MELBA MACABULOS ORTEGA ,both widow, both of legal
ages, Filipinos, residents of and with postal address at La Paz, Tarlac after having been duly sworn to on oath in
accordance with law do hereby depose and say:

That we personally know BRIGIDA P. SANTOS , of La Paz, Tarlac because we are close friends and town
mates;

That we know that BRIGIDA P. SANTOS is the only child of the late AGUSTINA DOMINGO who died
sometime on October of 1924, and the sole legal heir over a certain share on parcel of land consisting one-fifth
(1/5) which is particularly described as follows:

“ A parcel of land (Lot No. 192 of the Cad. Survey of La Paz, G.L.R.O. Rec. No. ____),
situated in the Bo. Of Caut, Municipality of La Paz, Province of Tarlac. Bounded on the NE, by Lot
No. 189 of La Paz Cadastre; on SE, by Lot No. 193; on the SW by road; and on the NW by Lot 189
of the La Paz Cadastre…. Containing an area of FOUR THOUSAND NINE HUNDRED EIGHTY FIVE
( 4,985 sq. m.) square metres more or less.

That Brigida P. Santos sold, transferred and conveyed by virtue of an Extra Judicial Partition with Sale of
Rights, Interest and Participation over the above-described share on the parcel of land that she inherited from her
mother – Agustina Domingo to spouses Dominador Mallari and Virginia Mallari of Caut, La Paz, Tarlac; as
evidenced by the Deed of Extra Judicial Partition with sale of Right, interest and participation executed before the
Notary Public Jesus R. Calderon on April 6, 1956 at La Paz, Tarlac ;with Doc. No.68; Page no. 5; Book No. VII; Series
of 1956.

That on said document, her mother’s name was recorded as Agustina Cornelio; which is not correct; The
correct name of her mother should be Agustina Domingo; That the surname Cornelio was not actually her surname
but it is the first name of his brother Cornelio Domingo;

That we know the foregoing fact because we are personally present when Brigida P. Santos executed the
Deed of Extra Judicial Partition with sale of Right, Interest and Participation;

That the discrepancy on Agustina’s surname was the fault of the person who assisted on accomplishing
the said document;

That this affidavit is executed to correct Agustina’s surname from Cornelio to Domingo and to establish
that Agustina Cornelio as appearing on the Extra Judicial Partition with sale of Right, Interest and Participation and
Agustina Domingo is one and the same person.

IN WITNESS WHEREOF, we have set our hands on this instrument this ___ day of _______________ at Tarlac City.

REGINA ALCANTARA PELEGRIN MELBA MACABULOS ORTEGA

Affiant Affiant
CTC. No. Exempted due to old age CTC. NO. ___________
Issued on ___________
Issued at ____________

Republic of the Philippines )

Province of Tarlac ( ) S.S.
Tarlac City )

SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and in the Province of Tarlac, this ___ day of
February 2016 at Tarlac City.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc. No. ______;

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