Republic of the Philippines

City of Tacloban

)
) SS

AFFIDAVIT
I, JOSE PROTACIO A. MENDIGO, a senior citizen, Filipino
citizen, widower, and a resident of San Roque, Tanauan, Leyte, after
being first sworn according to law, hereby depose and state: THAT--1. I am the owner in fee simple of certain real properties in
Tanauan, Leyte, and more particularly described as follows:
a) Residential land covered by OCT No. P-89383, Residential Free
Patent No. 083748-01697 in the name of Jose Protacio A. Mendigo, with
an area of 147 sq.m. situated in Brgy. San Roque, Tanauan, Leyte, and
declared for taxation purposes in the name of MENDIGO, JOSE
PROTACIO under TD No. 38005 00249 R13 with a market value of
P35,188.86 only;
b) Residential land covered by OCT No. P-89384, Residential Free
Patent No. 083748-00667 in the name of Jose Protacio A. Mendigo, with
an area of 254 sq.m., situated in Brgy. San Roque, Tanauan, Leyte, and
declared for taxation purposes in the name of MENDIGO, PROTACIO &
FLORDELIZA, Sps. under TD No. 38005 00250 R13 with a market value
of P60,802.52 only;
c) Residential house declared for taxation purposes in the name
of Mendigo, Flordeliza & Protacio under TD No. 38005 00553 situated
at Don Lorenzo St., San Roque, Tanauan, Leyte erected on the land of
J.P. Mendigo under Cad. Lot No. 1044 with concrete and wood with
glass jalousie window, area of 75 sq.m. and with a market value of
P155,208.77 only.
2. The above described real properties have been donated by the
undersigned in favor of his only child GRACE R. MENDIGO through
DONATION INTER VIVOS duly executed, notarized and registered as
Doc. No. 120, Page No. 24, Book No. 62, Series of 2012 of the notarial
register of Notary Public Leo S. Giron.
3. This is the first and only donation executed by the
undersigned for the above described real properties.
4. This affidavit is executed for whatever legal purposes this may
serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature
this 27 February 2012 at Tacloban City, Philippines.
JOSE PROTACIO A. MENDIGO
Affiant
SUBSCRIBED AND SWORN to before me this 27 February 2012
at Tacloban City, affiants exhibiting to me his Community Tax

Certificate No. 07843998 issued on 20 February 2012 at Tanauan,

Leyte.
Doc. No. _____
Page No. _____
Book No. 62
SERIES OF 2012