REPUBLIC OF THE PHILIPPINES)

CITY OF _____ LIPA______) S.S.

AFFIDAVIT OF SELF-ADJUDICATION
I, Lily Cruz, of legal age, Filipino, single and a resident of 123 Ilang-
Ilang, Sampaguita, Lipa City after having been duly sworn to in
accordance with law, depose and state:
1. That I am the only child of Camia Cruz (Deceased) who died without
any last will and testament on January 1, 2023 in Lipa City, Batangas;
2. That at the time her death, my deceased mother had no debts,
liabilities or obligations to any persons, agency or institution;
3. That the only properties left by my deceased mother are a parcel of
land located in Rosas, Gumamela, Lipa City with a total area of 5,000
square meters covered by TCT No. 8910 and the residential house in
456 Ilang-Ilang, Sampaguita, Lipa City covered by TCT No. 5678.
4. As sole heir of the herein decedent, I hereby adjudicate the
abovementioned property solely for and in my name;
5. I hereby execute this affidavit for the purpose of processing the
transfer of the above-described property in my name, pursuant to the
provision of Rule 74, Section 1 of the Rules of Court of the Philippines
and hereby files the same with the request that said adjudication be
made effective without judicial proceeding as prescribed by the
aforementioned provision of the Rules of Court.

IN WITNESS WHEREOF, I have hereunto set my hand this 5th day of

February, 2023 in the City of Lipa, Batangas, Philippines.

Lily Cruz
__Lily Cruz __
AFFIANT

SUBSCRIBED AND SWORN to before me this _5th day of _February

2023__ at City of Lipa, Province of Batangas, Philippines, affiant
having exhibited to me her Competent Evidence of Identity by way of
her Driver’s License bearing No. 143-44 issued at Lipa City, Batangas
on July 25, 2022.

Notary Public
Doc. No. __116__;
Page No. __18___;
Book No. ___1___;
Series of __2023_.