REPUBLIC OF THE PHILIPPINES)

DONE IN THE CITY OF BAGUIO ) S.S.

AFFIDAVIT OF SELF ADJUDICATION
I, ESA ESPLAGO PIMENTEL, of legal age, single, Filipino Citizen with
residence and postal address at 3B Malaya Rd., Dominican, Baguio City after having
been duly sworn to in accordance with law hereby depose and state:
1. That I am the daughter of SARAH PIMENTEL OBRA who died last October
15, 2012 , a copy of her Certificate of Death is hereto attached as Annex A
and made an integral part hereof;
2. That my mother has a current Bank Deposit with ACCOUNT NO. 010-102980 with a balance of EIGHT THOUSAND FIVEHUNDRED FORTY FOUR AND
EIGTHY SIX CENTAVOS( Php 8,544.86) at the Diamond Rural Bank, Inc
with office at No. 2 Kayang Street, Baguio City;
3. That it is to the best of my interest I hereunto adjudicate unto myself the said
Bank Deposit;
4. That I am executing this affidavit to support my claim with regards to the Bank
Deposit with a balance of Php 8,554.86 at the Diamond Rural Bank, Inc., and
to attest to the veracity and truthfulness of the foregoing statement and for all
legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 13th day of
February, 2013 at Baguio City, Philippines.

ESA PIMENTEL
Affiant
SUBSCRIBED AND SWORN to before me this 13th day of February, 2013 at
Baguio City, Philippines. Affiant personally appeared before and identified by me
through her Social Security System ID No. 01-1696626-1 and to be the same person
who executed this Affidavit of Self-Adjudication freely and willingly.
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of 2013.