REPUBLIC OF THE PHILIPPINES)

CITY OF ___________…………….) S.S

AFFIDAVIT OF
APPOINTMENT OF ADMINISTRATOR

WE, _________________, ________________, ____________________after

having been sworn according to law, hereby depose and state:

That WE hereby NAME, APPOINT and CONSTITUTE

_______________________________________ as the administrator of our interests in
the real property as follows:

T.C.T. No. _____

“A parcel of land, (Lot 4 of the subdivision plan, (LRC)Psd-73828, being a
portion of 11-1197, L.R.C. (GLRO)Rec. No.8430, situated in the Municipality
of _______, Province of ____________, Island of ________. Bounded on the
NE. and SE., point 8 to 9___________________________, containing an area
of FORTY TWO THOUSAND SEVEN HUNDRED THIRTY TWO (42,732)
square meters…Registered in the name of ________________________”

That as the appointed administrator, he is authorized to transact with the BIR and
other government agencies and to receive all documents regarding the properties covered
by the Adjudication, from the BIR and to submit them to the R.O.D for registration
purposes;

IN WITNESS WHEREOF, we have hereunto set our hand this _______ day of
___________ at ____________________.

________________________
HEIR
ID no. _______________

____________________ _______________________
HEIR HEIR
ID no. _______________ ID no. _______________

CONFORME:

___________________________
APPOINTED ADMINISTRATOR

SUBSCRIBED AND SWORN to before me this __________day of _________

at _________________, affiants exhibited to me their IDs stated above.

Doc. No. _____

Page No. _____
Book No. _____
Series of _____