AFFIDAVIT OF SELF-ADJUDICATION
REPUBLIC OF THE PHILIPPINES)
CITY OF TAGUIG
S.S.
x-------------------------------------------------x
I, MS. GLORIA LOPEZ, of legal age, Filipino, and a resident of
_______________, under oath in accordance with law, hereby
state:
1. That I am the exclusive heir of the late MR. RAMON
LOPEZ, who passed away intestate on _____, in _____, as
substantiated by his Death Certificate issued by
____________, attached hereto as Annex “A” and forming an
integral part hereof;
2. That at the time of his demise, my father was not indebted
to any individual or entity;
3. That the sole estate left by my father is a parcel of land
measuring THREE HUNDRED FIFTY SQUARE METERS
(350 sq.m.), registered under Transfer Certificate of Title
(TCT) No. T-112233, located in Taguig City, a copy of which
is attached as Annex “B” and incorporated herein by
reference;
4. That in accordance with Rule 74, Section 1 of the Rules of
Court, I hereby appropriate and adjudicate unto myself the
aforementioned real property, and I hereby file this
Affidavit with the Registry of Deeds of Taguig City to effect
the transfer of ownership without judicial proceedings, as
permitted by the aforesaid rule.
IN TESTIMONY WHEREOF, I have hereunto set my hand this
___ day of __________, 20, in Taguig City.
_________________________
MS. GLORIA LOPEZ
Affiant
ACKNOWLEDGMENT
SUBSCRIBED AND SWORN TO before me this ___ day of
__________, 20, at Taguig City, affiant presented to me her
valid identification, __________________, issued on ____ at ____,
Philippines.
NOTARY PUBLIC
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of ______.