Declaration of Heirship Self Adjudication of Estate of Deceased Person

REPUBLIC OF THE PHILIPPINES ) PROVINCE OF LAGUNA ) SS MUNICIPALITY OF ALAMINOS )

AFFIDAVIT
I, JELA MAITIMTIMAN, of legal age, Filipino, single and a resident of No. 143 Municipality of Alaminos, Province of Laguna, Philippines, after having been duly sworn in accordance with law, do hereby depose and say: 1. That I am the only daughter of JOSE MAITIMTIMAN and JUANA MAITIMTIMAN. My mother Juana predeceased my father Jose who died intestate in the Municipality of Alaminos, Province of Laguna, on May 30, 2012 as evidenced by Death Certificate issued by the Municipality of Alaminos, Province of Laguna, hereto attached as ANNEX A and made an integral part of this Affidavit; 2. That the said deceased left no will; 3. That the said deceased left deposit in the Rural Bank of Alaminos, Inc., in the amount of P500,000; 4. That said deceased left a certain parcel of land covered by Transfer Certificate of Title No. 876543 and more particularly described as follows: A PARCEL OF LAND (Lot 20 Blk. 54 of consolidation subdivision plan (LRC) Pcs-13265, being a portion of the consolidation of Lots 4751-A and 4751-B (LRC) Psd-50533, Lot 3, Psd-100703, Lot 1, Psd-150980, LRC Rec. Nos. Nos. N-27024, 51768, 89632, N-11782, N-13466, and 21071 situated in the Bo. of San Dionisio, Municipality of Alaminos, Province of Laguna. Bounded on NE., point 4 to 1 by Road Lot 22, on...to the point of beginning; containing an area of (280) square meters more or less..." 5. That the said deceased left no debts; 6. 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 Laguna with the request that the said adjudication be made effective without judicial proceeding as prescribed by the aforementioned Rules of Court. IN WITNESS WHEREOF, I have set my hand this 20th day of July 2012 at Municipality of Alaminos, Province of Laguna, Philippines. JELA MAITIMTIMAN Affiant

SUBSCRIBED AND SWORN before me this 20th day of July 2012 at Municipality of Alaminos, Province of Laguna, Philippines.

PEDRO MAPANUMPA Notary Public, Alaminos, Laguna Appointment No: 12345 Commission to expire: December 31, 2013 Roll No: 10234 PTR No: 072608, July 21, 2012 IBP No: 67891. June 10, 2012, Alaminos, Laguna Office Address: Calamagui 2nd Alaminos, Laguna Doc. No. 23 Page no. 10 Book no. IV Series no. 2012