Affidavit of Adjudication by Sole Heir

of Estate of Deceased Person

AFFIDAVIT

REPUBLIC OF THE PHILIPPINES

PROVINCE OF ___________ SS
MUNICIPALITY OF__________

I, MARISSA MAYOR FUI, Jr. of legal age, single, resident of _______u City, being
first sworn in accordance with law, depose and say:

1. That I am the only surviving son of one, named MARCOS FUI, SR. who died
intestate in _______City, Philippines, on Jan 3, 2024 as evidenced by Death Certificate
issued by the Department of Health, hereto attached as ANNEX "A" and made an
integral part of this Affidavit;

2. That said deceased left an estate consisting of a parcel of land measuring five
thousand (5000) sq. m., located in the ___________ City , and evidenced by Transfer
Certificate of Title No. RT-1310 (T-11351) issued by the Register of Deeds of________
City;

3. That the said parcel of land is more particularly described as follows, to wit:

A parcel of land covered by TCT No. RT-1310 (T-11351) (Lot 1, of the

consolidation-subdivision plan Psd-08-123456, being a portion of Lots 1, 2 &3
Pos-08-123457 LRC Rec. No. N-14344), situated in the Barangay of Inilad, City
of Cardaba, Island of Corocain. Bounded on the NE., along line 1-2 by
Helanution Avenue 10.00m. wide, on the SE., along line 2-3 by Lot 2 of the
consolidation-subdivision plan, on the SE., along line 3-4 by Lot 2-B-2-B, Psd-
08-234567, on the NW., along line s 4-5-1 by property of Hoadola Holdings.
Beginning at a point marked “1” on plan being N. 80 deg. 09’E., from BLBM
No.2, Inilad Cardaba; thence S. 90 deg. 06’E., 12.28 m. t point 2; thence S. 27
deg. 42.06 m. to point 3; thence N. 15 deg. 00’W., 12.27 m. to point 4; thence N.
27 deg. 46’E., 21.23 to point 5; thence N. 37 deg. 46’E., 20.82 m. to point of the
beginning. Containing an area of FIVE THOUSAND (5000) SQUARE METERS,
more or less. All points referred to are indicated on the plan and marked on the
ground as follows: Point 1,4 & 5 by odl P.S. cyl. Conc. Cons., 10 x 60 cms. And
the rest by P.S. cyl. Conc. Mons., 10 x 40 cms. Bearings true. Dates of the
original survey, June 19-30, 1869 and that of the consolidation-subdivision
survey, executed by Geodetic Engr. Malvin Larion, on June 20, 1975, and
approved on May 25, 1977.

4. That said deceased left no debts;

5. That the net value of said estate is not more than Five Million Pesos
(P5,000,000.00), and is therefore exempt from the estate and inheritance taxes, as
evidenced by a certificate of exemption issued by the Bureau of Internal Revenue
hereto attached as ANNEX “B" and made an integral part of this affidavit;

6. That pursuant to Rule 74, Sec. 1 of the Rules of Court, I hereby adjudicate
unto myself the above described real estate by means of this Affidavit and hereby file
same with the Register of Deeds of Cebu City with the request that said adjudication
be made effective without judicial proceedings as prescribed by the aforementioned
Rules of Court.
 IN WITNESS WHEREOF, I have hereunto set my hand this 6th day of January,
2007, in the City of Cebu, Philippines.

MARISSA M. FUI
Affiant
ID ____________
Issued in _________
Expires _________

JURAT

SUBSCRIBED and sworn to before me, in the city/municipality of___________, this

_____________, ___________ by MARISSA M. FUI with ID detailed above.

NOTARY PUBLIC
My commission expires

Doc. No. ____;

Page ___________;
Book ___________;
Series of 2024