REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO ) S.S.

AFFIDAVIT OF SELF-ADJUDICATION

I, CATHERINE L. ORTEGA, of legal age, Filipino, single and a

resident of 456 Lorenzo St., Oton, Iloilo, after having been duly sworn to in
accordance with law, depose and state:

1. That I am the only daughter of CARA L. ORTEGA who died without

any last will and testament on July 20, 2019 in Oton, Iloilo as evidenced
by her Death Certificate issued by the City of Iloilo hereto attached
as Annex “A” and made an integral part of this Affidavit;

2. That at 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 120 square
meters located in Barrio of Wawa, Municipality of Parañaque, Metro
Manila, more particularly described in TCT No. 167965
hereto attached as Annex “B” and made an integral part of this
Affidavit;

4. 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 files the same with the Register of Deed of Iloilo
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 26th day

of January 2021 in Iloilo City, Philippines.

CATHERINE L. ORTEGA
Affiant

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 SUBCRIBED AND SWORN TO before me this 26th day of January
2021 in Iloilo City, Philippines, affiant exhibiting to me her Philippine Passport
No. 123456 issued in Manila on January 12, 2018 and valid until January 12, 2028
and Community Tax Certificate with no. 20 35307777 as competent evidence of
her identity.

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