EXTRAJUDICIAL SETTLEMENT OF ESTATE WITH

WAIVER

KNOW ALL MEN BY THESE PRESENTS:

This AGREEMENT made and entered into this _____ day

of ____________ 2021, in _________________, _______________
by and among:

______________________, of legal age, Filipino, widow,

and residing at Barangay San Vicente, Macrohon, Southern
Leyte;

________________, of legal age, Filipino married to

Josielda Nenit Tagra, and with postal address at Barangay San
Vicente, Macrohon, Southern Leyte;

___________________, of legal age, Filipino, single and

with postal address at Barangay San Vicente, Macrohon,
Southern Leyte;

_________________, of legal age, Filipino, married to

Ronwaldo Ray Siat and with postal address at Barangay San
Vicente, Macrohon, Southern Leyte;

-AND-

______________________, of legal age, Filipino, single and

residing at and with postal address at Barangay San Vicente,
Macrohon, Southern Leyte;

WITNESSETH, that:

1
 WHEREAS, we are the sole heirs of the deceased
______________, who died on September 12, 2021, at San
Vicente, Poblacion, Macrohon Southern Leyte. Copy of his
death certificate is hereto attached as Annex A;

WHEREAS, _________________ died intestate, without

Will or Testament, and without any outstanding debts in favor
of any person or entity;

WHEREAS, the deceased _______________ who was

married to _____________________, was the absolute and
registered owner of the following:

1. A parcel of land with improvements and located at,

_________________________ covered by Transfer Certificate of
Title No. 117-201600______________________0433, of the
Registry of Deeds of the for Maasin, Province of Southern
Leyte and more particularly described as follows:

“LOT NO. 3069-A PLAN NO: PSD-08-033830-D

PORTION OF: LOT 3069

LOCATION: BARANGAY POBLACION, MUNICIPALITY

OF MACROHON, PROVINCE OF SOUTHERN LEYTE, ISLAND
OF LEYTE.

LINE DIRECTION ADJOINING LOT(S)

1-2 SE LOT ____

2-3 SE LOT 3071, CAD. 643-D

MACROHON CADASTRE

PSD-08-033830-D

3-4 SW RIZAL STREET, PSD-08-

033830-D

4-5 NW LOT 3069, CAD. 643-D

2
 MACROHON CADASTRE,

PSD-08-033830-D

5-1 NE LOT 3069-B, PSD-08-

033830-D, PSD-08-033830-D

TIE POINT: BLLM NO. 1. CAD 657-D, MUNICIPALITY OF

MACROHON, PROVINCE OF SOUTHERN LEYTE

LINE BEARING DISTANCE

TO CORNER 1 N. 10” 19 E 203.43M

1-2 S. 58’ 02 W 21.59 M.

2-3 S. 58” 57 W” 9.48 M.

3-4 N. 32” 51’ W 22.45 M.

4-5 N.56” 14’ E 28.69 M.

5-1 S. 38” 37’ E 23.67 M.

AREA: ONE HUNDRED EIGHTY NINE SQUARE METERS

(189), MORE OR LESS”

2. A certain parcel of land consisting of ONE HUNDRED ONE

SQUARE METERS (101sqm) without improvements located at
Barangay Mohon, Macrohon and covered by Tax Declaration No. 07-
08-016-00281.

NOW THEREFORE, for and consideration of Sec 1, Rule

74 of the Revised Rules of Court of the Philippines, the parties
do by these presents, agree to an Extrajudical Settlement and
agree to ADJUDICATE the entire estate to
_______________________;

WAIVER

3
 ) We, __________________________ hereby WAIVE
our shares, rights and interests over all the real properties
above in favor of __________________.

b) I, __________________________, acknowledge the

generosity and liberality of my mother and siblings and I
hereby ACCEPT the waiver/donation of their share, rights, and
interest in the real properties above-mentioned;

COMPLIANCE WITH SEC 4, RULE 74, ROC

The EXTRAJUDICIAL SETTLEMENT in accordance with

the above, is subject however to the liabilities imposed under
Sec 4, Rule 74 of said Rules of Court, in favor of any possible
heir/s, creditors and other persons who might have been
deprived of their lawful participation in the estate of the
deceased for a period of two (2) years.

Hereunto set our hand on the _______ day of

_________________, 2021 at __________________________.

By:

The Heirs of ______________

Surviving Wife/Heir
TIN ID Number ___________

Surviving Child/Heir
TIN ID Number _________

Surviving Child/Heir
TIN ID Number _____________

Surviving Child/Heir

4
 TIN ID Number: ___________

Surviving Child/Heir

TIN ID Number ____________

SIGNED IN THE PRESENCE OF:

___________________________

___________________________

ACKNOWLEDGEMENT

Republic of the Philippines)

__________________ ) S.S

BEFORE ME, a Notary Public in and for the

_____________________, this _____ day of ______________,
personally appeared:

Name Identification Card Valid until/Expires on

who have satisfactory proven to me their identity that they are

the same person who executed and voluntarily signed the
foregoing EXTRAJUDICIAL SETTLEMENT OF ESTATE WITH
WAIVER which they acknowledged before me as their free and
voluntarily act and deed.

The foregoing instrument which relates to an Extrajudicial

Settlement of Estate with WAIVER consisting of Six (6) pages
including the page on which this acknowledgement is written,
has been signed on the left margin of each and every page by
the parties and the witnesses.

WITNESS MY HAND AND SEAL, this ____ day of

_______________, in _______________________, Philippines.

5
Doc. No. _______;

Page No. _______;

Book No. ______;

Series of 2021.