Affidavit Self Adjudication

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REPUBLIC

PROVINCE
MUNICIPALITY

OF

THE
OF

PHILIPPINES
PANGASINAN)

OF

)
SS.
ALAMINOS)

AFFIDAVIT OF SELF-ADJUDICATION
I, JUAN DELA CRUZ of legal age, single, with residence address at #1407B PALM
TOWERS CONDOMINIUM ST. PAUL ROAD, SAN ANTONIO VILLAGE, MAKATI CITY after
having been duly sworn on oath in accordance with law, hereby depose and say:
1That I am the only son and sole heir of one JOSE DELA CRUZ and MARIA DELA CRUZ
who died intestate on JANUARY 16, 2016 at a vehicular accident in Brgy. Calasiao,
Pangasinan;
2That said deceased left a parcel of land located at Brgy. Calasiao, Pangasinan
covered by TRANSFER CERTIFICATE OF TITLE NO. 178934, of the Register of Deeds in
Pangasinan
and
more
particularly
described
as
follows:
A parcel of land (Lot 1-B-35, Bsd-1-000723 AR), being a portion of lot 1-B
& 1-C (LRC)
PSD-220089. Bounded on the E., along line 4-1 by lot 1-A;
Psd- 220089; on the S., along line
1-2 by lot 1-B-34; on the W., along line 2-3 by
lot 1-C-36; and on the N., along line 3-4 by lot 1B-36; all of the subdivision
plan. Beginning at a point marked 1 on plan being S 28 deg 56E.,
641.86 m.
from BLBM No. 1, Bo., Calasiao, Pangasinan
containing an area of TWO THOUSAND SIX HUNDRED FORTY (2,640),
SQUARE
METERS, more or less.
3That the decedent left no debts, nor any LAST WILL or TESTAMENT;
4That pursuant to Sec. I of Rule 74 of the Revised Rules of Court of the Philippines, I
hereby adjudicate unto myself the parcel of land above-described, and I hereby request
the Register of Deeds of Alaminos, Pangasinan to register and render the same effective;
5That the above realty does not come under the operation of the Land Reform Code.
IN WITNESS WHEREOF, I have hereunder signed my name this February day of 5
2016; at Alaminos, Pangasinan.
WITNESS:
Shia

Marie

Tayug

SUBSCRIBED AND SWORN to before me this February 5, 2016 at Alaminos,


Pangasinan. Affiant exhibited to me his Drivers License A0-122342 issued on May 3,
2014 at LTO - Pangasinan as his competent evidence of identity.
Doc. No.32;
Page No.1;

Book No.1;
Series of 2016.

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