AffldavlL of Ad[udlcaLlon by Sole Pelr of LsLaLe of ueceased erson

AffldavlL

8Lu8LlC Cl 1PL PlLllnLS )
Cl1? Cl lLClLC ) SS

l Crace Ann Sumayao of legal age slngle and now resldlng aL !aro llollo ClLy hlllpplnes afLer
Pavlng been sworn ln accordance wlLh law depose and say

1 1haL l am Lhe only survlvlng daughLer of 8odrlgo L Sumayao who dled lnLesLaLe ln Lhe
munlclpallLy Callnog llollo hlllpplnes on CcLober 16 2011 as evldenced by ueaLh CerLlflcaLe
lssued by Lhe Local Clvll 8eglsLrar hereLo aLLached as Annex A" and made an lnLegral parL of Lhls
AffldavlL
2 1haL sald deceased lefL an esLaLe conslsLlng of a parcel of land measurlng 1en Lhousand sq m
locaLed ln Lhe 8arangay Callnog munlclpallLy of Callnog and evldenced by 1ransfer of 1lLle no S
38733 of Lhe 8eglsLry of ueeds of llollo ClLy
3 1haL sald parcel of land ls more parLlcularly descrlbed as follows

All LhaL loL plece of land slLuaLed lylng and belng ln Lhe assessmenL ulsLrlcL of Callnog
munlclpallLy loL 1 SecLlon 3 sald land belng shown on plaL enLlLled and recorded among Lhe Land
8ecords of Callnog MunlclpallLy ln book no 3 pages 1 Lo 3

4 1haL sald deceased lefL no debLs

3 1haL neL value of sald esLaLe ls noL more Lhan Len Lhousand pesos (1000000) and sls Lherefore
exempL from Lhe esLaLe and lnherlLance Laxes as evldenced by a cerLlflcaLe of exempLlon lssued
by Lhe 8ureau lnLernal 8evenue hereLo aLLached as Annex 8" and made an lnLegral parL of Lhls
affldavlL

6 1haL pursuanL Lo 8ule 74 Sec 1 of Lhe 8ules of CourL l hereby ad[udlcaLe unLo myself Lhe above
descrlbed real esLaLe by means of Lhls affldavlL and hereby flles Lhe same wlLh Lhe 8eglsLer of
ueeds llollo ClLy wlLh Lhe requesL LhaL sald ad[udlcaLlon be made effecLlve wlLhouL [udlclal
proceedlngs as prescrlbed by Lhe aforemenLloned 8ules of CourL

ln Wl1nLSS WPL8LCl l have hereunLo seL my hand Lhls 2
nd
day of uecember 2011 ln llollo ClLy
hlllpplnes



________________________
( SlgnaLure of AfflanL )



Su8SC8l8Lu and sworn Lo before me Lhls 2
nd
day of uecember 2011 ln Lhe ClLy of llollo by !ose Marla
!ude uuremdes wlLh assporL no xx0892032 lssued on Aprll 9 2008 aL ueparLmenL of lorelgn Affalrs
uavao



uoc no 36 nC1A8? u8LlC
age no 12 Commlsslon Serlal no
8ook no lv unLll uecember 31 2011
Serles of 2011 8oll of ALLorney 46248
l8 no 823891
18 no 3824771