REPUBLIC OF THE PHILIPPINES )

MUNICIPALITY OF SARIAY )
X-----------------------------------------X

DEED OF DONATION
KNOW ALL MEN BY THESE PRESENTS:

This DEED OF DONATION is made and executed into this 31 August 2019
at Lucena City by and between:

Juan dela Cruz, of legal age, Filipino, married with residence and postal
address at Polandok, Sariaya, Quezon hereinafter called the DONOR;

-and-

THE PROVINCIAL GOVERNMENT OF QUEZON, a local government

unit formed and organized under the existing laws of the Philippines,
represented by GOV. PEDRO TUBIL, hereinafter called the DONEE;

WITNESSETH THAT:

The DONOR is the absolute and exclusive owner of a parcel of land

situated at Barangay Polandok, Sariaya, Quezon, containing an area of
TWENTY THOUSAND (20,000) SQUARE METERS, more or less known as
Lot 1111-pt and declared for taxation purposes under Tax Declaration
No. 11-1111-11111 with corresponding Property Index No. 111-11-1111-
111-11 with assessed value of P11,760.00 for the taxable year 2011.

For and in consideration of the generosity of the DONOR by these presents

have ceded, transferred and conveyed, by way of DONATION, unto said
DONEE, the above-described property together containing an area of TWO
HUNDRED (200) SQUARE METERS, with all the improvements existing
thereon, free from all liens and encumbrances as identified by the parties
with temporary markers on the ground.

It is agreed that the lot subject of the donation will be used for the
construction of reservoir and pumping station in Barangay Polandok,
Sariaya, Quezon.

The DONOR does hereby state, that he has reserved unto himself in full
ownership (or in usufruct) other properties sufficient to support him
according to her station in life. Moreover, this DONATION is not executed
in fraud of creditors as the DONOR has more than sufficient properties to
answer for any prior debts contracted by the DONOR.
All expenses for the segregation survey, issuance of title, fees and taxes in
connection with this donation shall be for the account of the DONEE.

This donation is subject to the condition that the donated lot shall not be
sold, transferred or alienated to any person, entity or corporation. It is
further subject to the condition that if for any cause or circumstance that
the lot is no longer used or needed by the DONEE, the same shall revert to
the DONOR or his successors-in-interest.

ACCEPTANCE:

The DONEE does hereby accept this donation and further expresses his
profoundest appreciation and thanks for the kindness and generosity
shown by the DONOR.

IN WITNESS WHEREOF, we have hereunto signed this Deed of Donation

Inter Vivos, this 31 August 2019 in the City of Lucena, Province of Quezon.

JUAN DELA CRUZ

Donor

Accept for and in behalf of the Provincial Government of Quezon,

by virtue of SP Resolution No. _____ dated _____________.

HON. PEDRO TUBIL

Donee

SIGNED IN THE PRESENCE OF:

______________________ ______________________

ACKNOWLEDGMENT

BEFORE ME, this 31 August 2019, in the City of Lucena, personally

appeared Pedro dela Cruz showing his valid identification card evidenced
by OSCA ID No. LBP-11-1111 issued by Barangay Polandok, known to me
to be the same person who executed the foregoing instrument and
acknowledged that the same is his free act and deed.

This instrument relates to the Deed of Donation with corresponding

Donee’s Acceptance, consisting of three (3) pages, including the page on
which this acknowledgment is written, and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my

notarial seal this on the date and place above written.

NOTARY PUBLIC

Doc. No.
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