Affidavit of Self-Adjudication

REPUBLIC OF THE PHILIPPINES}
DONE: IN THE CITY OF BAGUIO } S.S.

x ------------------------------------------- x
AFFIDAVIT OF LEGITIMATION
We, the spouses NATHAN D. QUIZON and YNA B. USON-QUIZON, both of legal age,
Filipinos, with residence and postal address at #47 Quisumbing St., Trancoville, Baguio City,
Philippines, having been duly sworn in accordance with law, do hereby depose and state that:
1. We were sweethearts and started cohabitating as husband and wife as early as 2008;
2. Out of our relationship was born a son on March 3, 2011 whom we named JASON
RODERICK;
3. As our son was born out of wedlock, he is considered illegitimate and he bears the family name
of his mother which is USON;
4. We subsequently got married on August 23, 2013 at St. Joseph Parish Church in Pacdal, Baguio
City as evidenced by our Certificate of Marriage;
5. At the time of the birth of our child, JASON RODERICK, we possessed all the qualifications
and none of the disqualifications to marry each other;
6. As a result of our marriage, the status of our child is legitimized and as such, he shall now bear
the family name of his father which is QUIZON;
7. We execute this affidavit to attest to the truth of the foregoing statements and for the purpose of
causing the legitimation of the status of our child, JASON RODERICK and for all legal intents
and purposes this may well serve;
IN WITNESS WHEREOF, we hereunto set our hands this 27th day of November, 2013 in the City
of Baguio, Philippines.
________________________ __________________________
NATHAN D. QUIZON YNA B. USON-QUIZON
Affiant Affiant
Passport No. JJ8823089 Passport No. QQ7644120
Valid until December 21, 2015 Valid until March 3, 2017
SUBSCRIBED AND SWORN to before me this 23rd day of November, 2013 at Baguio City,
Philippines, the affiants personally appearing and exhibiting to me their Passport numbers indicated
below their names as proof of their identities, and that they are the same person who personally signed
the foregoing affidavit before me and acknowledged that they executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Until December 31, 2014
4F La Azotea Bldg., Session Road, Baguio City
Tel No.: (074)-442-3396
PTR No. 23232; 1/07/2011; Baguio City
IBP OR No: 7654321; 1/07/2014; Baguio City
Doc. No. 12; Roll No.: 82112; 4/08/2004
Page No. 1; Serial No.: 74-NC-12 ®
Book No. l; MCLE Compliance No.: IV-34458; 04/28/2014
Series of 2013
x ------------------------------------------- x
AFFIDAVIT OF TRANSFEROR or TRANSFEREE
I, ELENA GRANA P. GALLARDO, single, of legal age, Filipino citizen and a resident of
#78-D Guisad, Surong Ext., Baguio City, Philippines, after having been sworn to in accordance with
law, do hereby depose and state that:
1. My total aggregate landholdings, including that parcel of land containing a land area of ONE
HUNDRED (100) SQUARE METERS, located at Tuding, Itogon Benguet, that I sold to
FLORA ANNE SANTOS, thru a Deed of Absolute Sale of a Registered Land covered by Doc.
No. 12; Page No. 2; Book No. I; Series of 2013 of the Notarial Registry of Atty. GERALD A.
GERONIMO of Baguio City, Philippines, dated April 21, 2013, does not exceed FIVE (5)
hectares;
2. I am executing this affidavit in compliance with Department of Agrarian Reforms

Administrative Order no. 1-89, as well as to show proof that my total aggregate land holdings,
including the portion of land I sold to FLORA ANNE SANTOS does not exceed five (5)
hectares;
IN WITNESS WHEREOF, I have hereunto set my hands this 23rd day of November 2013, in the
City of Baguio, Philippines.
________________________________
ELENA GRANA P. GALLARDO
Affiant
TIN: 888-327-911
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 23rd day of
November 2013, by ELENA GRANA P. GALLARDO, who has satisfactorily proven her identity
through:
Judy Ann Pecson, with Passport No. DD5353231, valid until February 14, 2017.
Kathryn Maghirang, with Passport No. KK8889878, valid until April 18, 2014.
who personally know the principal, to be the same person who executed and personally signed the
foregoing affidavit before me and acknowledged that she executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Roll No.: 82112; 4/08/2004
Commission Serial No.: 74-NC-12 (R)
MCLE Compliance No.: IV-34458; 04/28/2014
Doc. No. 18;

Page No. 1;
Book No. I;
Series of 2013
x ------------------------------------------- x
AFFIDAVIT OF SELF-ADJUDICATION
I, Robert S. Basco, of legal age, Filipino, single and a resident of No. 115 Maria Basa, Pacdal,
Baguio City, Philippines, after having been duly sworn in accordance with law, do hereby depose and
say:
1. That I am the only heir of Sigfred F. Basco who died intestate in the City of Baguio, on
September 3, 2012 as evidenced by Death Certificate issued by the Civil Registrar of Baguio,
hereto attached as ANNEX “A” and made an integral part of this Affidavit;
2. That said deceased left an estate consisting of a parcel of land measuring ONE THOUSAND
(1,000) SQUARE METERS, located at Mary Hills Road, Loakan Proper, Baguio City covered
by Transfer Certificate Title No. CC-19876 of the Registry of Deeds of Baguio City;
3. That the said parcel of land is more particularly described as follows to wit;
LOT 21 (LRC) CC-19876
“A parcel of land (Lot 21 of Subdivision plan LRC) CC-19876 being a

portion of the parcel of land described on TS-V-789D, l\LRC Rec. No. TS sales
Pat.) situated in Res. Sec. City of Baguio, island of Luzon, Philippines.
Bounded on the N.E point 5 to 7 y Subdivision Road (1, 000 m. Wide); on the
SW., points 5 to 1 by Lot 2, of the Subdivision Plan; and on the NW., points 1 to
2 by Lot 9, Block 2. Beginning at point marked “I” on plan, being N 43 deg 21
deg’ E, 321.70 m. from the main gate.
thence N 25 deg. 00’E, 40.00 m to point 2;

thence E 23 deg. 00’E, 32.00 m to point 3;
thence N 52 deg. 13’E, 11.00 m to point 4;
thence S 75 deg. 00’E, 456.00 m to point 5;
thence N 53 deg. 00’E, 13.00 m to point of beginning;
containing an area of ONE THOUSAND 1000 SQUARE METERS, more or

less. All points referred to are indicated on the Plan and marked on the ground
as follows; Points 1 to 4 by OLD points and the rest by PS cyl conc. Mons. 100
x 213 cm; bearings true; date of Original Survey, April 2 1982 and that of
Subdivision Survey executed by Gilbert M. Gunnawa, a Geodetic Engineer on
April 12, 1990.
4. That pursuant to Rule 74, Section 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 Deeds of Baguio City with the request that said adjudication be made effective
without the judicial proceeding as prescribed by the aforementioned Rules of Court.
IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of November 2013 at
Baguio City, Philippines.
_____________________
Robert S. Basco
Affiant
November 2013, by Robert S. Basco, personally known to me, who is the same person who personally
signed before me the foregoing affidavit and acknowledged that he executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Roll No.: 82112; 4/08/2004
Doc. No. 2;
Page No. 2;
Book No. I;
Series of 2013
x ------------------------------------------- x
AFFIDAVIT OF ADJUDICATION OF ESTATE OF DECEASED PERSON
I,Arnee D. Pito, of legal age, Filipino citizen, single and now residing at # 32 Ledesma St.,
Aurora Hill, Baguio City, Philippines, after having been duly sworn in accordance with law, do hereby
depose and say:
1. That I am the only surviving heir of one, named Jojo G. Pito who died intestate in
Trancoville, Baguio City, on December 19, 2011 as evidenced by Death Certificate issued by
the Civil Registrar of Baguio City hereto attached as ANNEX “A” and made an integral part of
this Affidavit.
2. That the said deceased left a deposit in the Philippine National Bank, in the amount of
Five Hundred Thousand Pesos (P500,000.00);
3. That said deceased also left a 2-bedroom condominium unit, located at #288, Twin
Towers Condominium, Leonard Wood Road, Baguio City, with an area of SEVENTY EIGHT
(78) SQUARE METERS more or less, covered by Condominium Certificate Title No. 188521
of the Register of Deeds of Baguio City;
4. That the said deceased left no debts;
5. That pursuant to Rule 74, Sec. 1 of the Rules of Court, I hereby adjudicate unto myself
the above described real and personal property by means of this Affidavit and hereby files the
same with the Register of Deed of Baguio City with the request that the said adjudication be
made effective without judicial proceeding as prescribed by the aforementioned Rules of Court.
6. That I am willing to pay a file bond in an amount equivalent to said deposit.
IN WITNESS WHEREOF, I have hereunto set my hand this 23 rd day of November, 2013, at
_________________________
Arnee D. Pito
Affiant
November 2013, by Ms.Arnee D. Pito who exhibited to me her Passport No. CC957742, valid until
February 14, 2017 as competent proof of her identity, andwho is the same person who personally
signed before me the foregoing affidavit and acknowledged that she executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Doc. No. 1; IBP OR No: 7654321; 1/07/2014; Baguio City
Page No. 1; Roll No.: 82112; 4/08/2004
Book No. I; Serial No.: 74-NC-12 ®
Series of 2013 MCLE Compliance No.: IV-34458; 04/28/2014
REPUBLIC OF THE PHILIPPINES }
x-------------------------------------------x
AFFIDAVIT OF GUARDIANSHIP
I, ANGELITO T. AMANFLOR, widow, of legal age, Filipino citizen, with residence and
postal address at No. 16 Old Lucban, Baguio City, after having been duly sworn to in accordance with
law, hereby depose and state:
1. That I am the father of my daughter ANGELA P. AMANFLOR by my deceased wife,

ANGELINA P. AMANFLOR, who died on July 18, 2011;
2. That by reason of the death of my above-named wife, I henceforth become the father and
guardian of my said daughter as she is still a minor having been born on March 15, 2005;
3. That I am executing this affidavit in order to attest to the truth of the foregoing
circumstances and for the purpose of securing an educational insurance for my said
daughter in my capacity as her guardian.
IN WITNESS WHEREOF, I have hereunto set my hands this 23 rd day of November 2013 in
_______________________________
ANGELITO T. AMANFLOR
Affiant
SUBSCRIBED AND SWORN to before me in the City of Baguio this 23rd day of November
2013, by ANGELITO T. AMANFLOR, who has satisfactorily proven his identity through:
LEILA UY, with Passport No.XX832653, valid until February13, 2016

DIVINA CY, with Passport No.XX164314, valid until February 6, 2014
who personally know the principal, to be the same person who executed and personally signed
the foregoing affidavit before me and acknowledged that she executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Page No. 1; Roll No.: 82112; 4/08/2004
x ------------------------------------------- x
AFFIDAVIT OF DISCREPANCY OF SURNAME/FAMILY NAME
I, ALEXIS SERAPION ZARATE, of legal age, married, Filipino and a resident of #25-A
Silver St., Tacay, Quezon Hill, Baguio City, Philippines having been duly sworn in accordance with
law, do hereby depose and state:
1. That on October 25, 2007 I was issued a Philippine Passport with the number for identification
MM8874321 in which my true surname ZARATE was stated;
2. That before the expiration of the aforementioned passport on October 25, 2013, I had applied
with the Department of Foreign Affairs in Manila for the issuance of a new passport and on
November 5 2013, I was issued a new Philippine passport with passport no. MM4332311;
3. However, in the said new passport my surname had been erroneously misspelled as
“ZARAETE” instead of “ZARATE”;
4. That I execute this Affidavit of Discrepancy to attest to the truth of the foregoing facts and to
explain the discrepancy in my Philippine Passport with regards my surname.
IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of November, 2013, at
___________________________
ALEXIS SERAPION ZARATE
Affiant
November 2013, by Mr. ALEXIS SERAPION ZARATE who exhibited to me his Postal ID No.
4082351, valid until September 11, 2015 as competent proof of his identity, and who is the same person
who personally signed before me the foregoing affidavit and acknowledged that he executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Roll No.: 82112; 4/08/2004
Doc. No. 9;
Page No. 1;
Book No. I;
Series of 2013
DONE: IN THE CITY OF BAGUIO }
x ------------------------------------------- x
AFFIDAVIT OF DESISTANCE
I, NESTOR D. HERNANDEZ, single, of legal age, Filipino citizen, with residence and postal
address at #12 Cabinet Hill, Baguio City, after having been duly sworn in accordance with law, do
hereby depose and state:
1. That I am the Private Complainant in Criminal Case No. 35667-R for violation of B.P. Blg.
22 otherwise known as the Bouncing Checks Law now pending before the Municipal Trial
Court, Baguio City, Branch 3;
2. That the accused SATURNINO G. DELA CRUZ has settled his obligations with me to my
full satisfaction;
3. That due to the aforementioned reason, I freely and voluntarily pray for the FINAL
DISMISSAL of the case against SATURNINO G. DELA CRUZ;
4. That I am no longer interested to pursue the case against said SATURNINO G. DELA
CRUZ;
5. That I am now requesting the Office of the City Prosecutor of Baguio City and the
Honorable Court, Regional Trial Court, Branch 3 of Baguio City to have the case withdrawn
against SATURNINO G. DELA CRUZ;
6. That I am executing this Affidavit of Desistance to attest to the truth of all the foregoing
facts, as well as, to withdraw my complaint against SATURNINO G. DELA CRUZ, and
ultimately have the case against him be dismissed.
IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of November 2013, in
the City of Baguio, Philippines.
_______________________
NESTOR D. HERNANDEZ
Affiant / Private Complainant
Passport No. GG8553423
CERTIFICATION
This is to certify that I have personally examined the affiant and I am convinced that he
voluntarily executed his statement and understood the contents thereto.
___________
Anthony Zamora
Public Prosecutor
x ------------------------------------------- x
AFFIDAVIT OF CONSENT FOR TRAVEL OF A MINOR ABROAD
We, JOHN C. CAYABYAB and ELENA C. CAYABYAB, married to each other, of legal ages,
Filipinos, with residence and postal address at #31-G Baltazar, Brgy. Gibraltar, Mines View, Baguio
City, Philippines, and with Taxpayer Identification Nos. (T.I.N.) 121-244-588 and 114-389-911,
respectively, after having been duly sworn in accordance with law, do hereby depose and state:
1. That we are the parents of ARLENE C. CAYABYAB, Filipino, 12 years old, and
who is going to Washington DC, USA this December 15, 2013;
2. That we are giving our full consent to our said daughter to travel to Washington
DC, USA, in the company of her doctor, Dr. Herbert Lopez with whom she will be staying for
the entire duration of her trip;
3. That we are hereby giving our full consent to said Dr. HERBERT LOPEZ to
accompany or escort ARLENE C. CAYABYAB in her travel abroad;
4. That for this purpose, we have sufficient and adequate financial capacity to support
and defray the said travel and do hereby undertake to finance her trip abroad from the
application fees, airline tickets, board and lodging, pocket money and such other expenses that
she may incur so that she would neither be a burden to the state nor at their place of destination
at any time during her trip abroad;
5. That we are executing this affidavit to declare the truth of the foregoing facts and
for whatever legal purpose it may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this 23rd day of November 2013 in
the City of Baguio, Philippines.
______________________________ ________________________
JOHN C. CAYABYAB ELENA C. CAYABYAB
Affiant Affiant
SUBSCRIBED AND SWORN to before me in the City of Baguio this 23 rd day of November
2013 through Kate Mercedes Estanillo and Eunice Cenezan, who are personally known to me and who
are the same persons who personally signed before me the foregoing and acknowledged that they
executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Page No. 1; Roll No.: 82112; 4/08/2004
x ------------------------------------------- x
AFFIDAVIT OF BIRTH BY TWO DISINTERESTED PERSONS
WE, Terrence D. Soliman and Nancy S. Pascual, both Filipinos, of legal ages, both
married, and presently residing at 55C Burgundy Lane, Rainbow Hills Subdivision, Fairview,
Baguio City and at #2 La Cheza Rd., Irisan, Baguio City, respectively, both after having been
duly sworn in accordance with law, do hereby depose and say:
1. That we personally know MIRASOL GOMEZ FERNANDO of #7 Badihoy St., Guisad,

Baguio City, being acquaintance for a long period of time;
2. That she is a PAG-IBIG Fund member with an application for Provident Benefits with
the Fund;
3. That the said application is required to be accompanied by a copy of the applicant’s

birth certificate, however, no record can be obtained, as shown by the attached
Certification of Non-Availability of Birth Record from the National Statistics Office
(NSO);
4. That we certify that she was born at Baguio General Hospital, Baguio City Philippines,
on the 14th day of February in the year 1977 ;
5. That she has been using the said birth date in all her documents and transactions,
including her education and employment records;
6. That we are not related by affinity or consanguinity to the above mentioned person
neither are we interested in the purpose for which this affidavit is being executed; and
7. That we are executing this affidavit to attest to the truth of the foregoing facts for record
and references purposes.
IN WITNESS WHEREOF, we have hereunto set our hands this 23 rd day of November
2013, at Baguio City, Philippines.
___________________ ____________________
Terrence D. Soliman Nancy S. Pascual
Affiant Affiant
CTC No. 28738278 CTC No. 39824983
Issued on January 17, 2013 Issued on March 15, 2013
Issued at Baguio City Issued at Baguio City
SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 23 rd
day of November 2013, by Terrence D. Soliman and Nancy S. Pascual, who have
satisfactorily proven their identities through:
Terrence D. Soliman, with Passport No. BB5593189, valid until February 14, 2016.
Nancy S. Pascual, with Passport No. SS8533100, valid until April 18, 2013.
who personally know the principal, to be the same persons who executed and personally
signed the foregoing affidavit before me and acknowledged that they executed the same.
JO-ANNE M. VENTIGAN
Notary Public
Tel No.: (074)-442-3396
Roll No.: 82112; 4/08/2004
Doc. No. 3;
Page No. 2;
Book No. I;
Series of 2013

Affidavit of Self-Adjudication

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Affidavit of Self-Adjudication

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REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.

AFFIDAVIT OF TRANSFEROR or TRANSFEREE

2. I am executing this affidavit in compliance with Department of Agrarian Reforms

Doc. No. 18;

LOT 21 (LRC) CC-19876

“A parcel of land (Lot 21 of Subdivision plan LRC) CC-19876 being a

thence N 25 deg. 00’E, 40.00 m to point 2;

containing an area of ONE THOUSAND 1000 SQUARE METERS, more or

AFFIDAVIT OF ADJUDICATION OF ESTATE OF DECEASED PERSON

4. That the said deceased left no debts;

6. That I am willing to pay a file bond in an amount equivalent to said deposit.

1. That I am the father of my daughter ANGELA P. AMANFLOR by my deceased wife,

LEILA UY, with Passport No.XX832653, valid until February13, 2016

AFFIDAVIT OF DISCREPANCY OF SURNAME/FAMILY NAME

AFFIDAVIT OF CONSENT FOR TRAVEL OF A MINOR ABROAD

AFFIDAVIT OF BIRTH BY TWO DISINTERESTED PERSONS

1. That we personally know MIRASOL GOMEZ FERNANDO of #7 Badihoy St., Guisad,

3. That the said application is required to be accompanied by a copy of the applicant’s

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