Republic of the Philippines)

Province of Southern Leyte) S. S.

City of Maasin...............)

AFFIDAVIT
(NO PREVIOUS DONATION)

I, MARIE JO ANN V. UMPAD, of legal age, Filipino, married to REYNALDO T. UMPAD,

and a resident of Setro Tulay, Minglanilla, Cebu, Philippines, after having been duly sworn to in
accordance with law, depose and say:

1. That I am the biological daughter of MILDRED SEGALES VECINA who died intestate on
May 6, 2020 at Tacloban City, Leyte, Philippines;

2. That along with my two other siblings, MARIA PAMELA SEGALES VECINA and MAHALIA
FAITH VECINA-GUDMALIN, we executed a Deed of Extrajudicial Settlement with Waiver
of Rights, in relation to the personal property left by our deceased mother;

3. That such personal property pertains to the shares of stock and savings account at the
Rural Bank of Malitbog;

4. That in the said Deed of Extrajudicial Settlement, which is hereto attached, my sister,
MARIA PAMELA SEGALES VECINA, waived, transferred and conveyed her rights and
interests over the above-mentioned shares of stock and savings account, in favor of me
and my sister MAHALIA FAITH;

5. That to best of my personal knowledge, this is the only donation or waiver she made,
and that she has made no other waiver or donation to any other person(s) involving the
said shares of stock and savings account;

6. Furthermore, this is the first and only donation she made for the year 2022;

7. That I am executing this affidavit to attest to the veracity of the foregoing, and for
whatever purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set/affixed my signature this ___________________

at Maasin City, Southern Leyte, Philippines.

MARIE JO ANN V. UMPAD

Affiant

SUBSCRIBED AND SWORN TO before me this _______________ at Maasin City,

Southern Leyte, Philippines.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2022