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REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI
) S.S.
x---------------------------------x
AFFIDAVIT OF SELF-ADJUDICATION
I, MARIA B. DELA CRUZ, of legal age, Filipino, single and a resident of 6789 Washington
Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law, depose
and state:
1. That I am the only daughter of JUAN B. DELA CRUZ who died without any last will
and testament on July 20,2013 in Makati city as evidenced by his death certificate issued
by the city of Makati hereto attached as Annex A and made an integral part of this
Affidavit;
2. That the time his death, my father had no debts, liabilities or obligations to any persons,
agency or institution;
3. That the only property he left is a parcel of land consisting of 60 square meters located in
J.B. Roxas Street, Makati City more particularly described in TCT No. 112233 hereto
attached as Annex B and made an integral part of this Affidavit;
4. That pursuant to the Rule 74, Sec. 1 of Rules of Court, I hereby adjudicate unto myself
the above described real estate by means of this Affidavit and hereby files the same with
the Register of Deed of Makati City with the request that the said adjudication be made
effective without judicial proceeding as prescribed by the aforementioned provision of
the Rules of Court.
IN WITNESS WHEREOF, I have hereunto set my hand this 26 th day September 2013 in
May 2013 in Makati City, Metro Manila, Philippines.

MARIA B. DELA CRUZ


Affiant
SUBSCRIBED AND SWORN TO before me this 26th day of September 2013 in Makati
City, Metro Manila, Philippines, affiant exhibiting to me her Philippine Passport No. 123456
issued in Manila on January 12,2012 and valid until January 12,2017.

Atty . Elmer Juan Jr.


Notary Public for Makati City
Door 16, 7th Street , Bangkal , Makati City
Roll of Attorneys No. 10
PTR No. 12345, issued on Jan. 03, 2013 Makati City
IBP No. 101010; issued on Jan. 02, 2013
Makati City Chapter
MCLE Compliance No.12345

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2013.

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