REPUBLIC OF THE PHILIPPINES)

CITY OF PARAÑAQUE ) S.S.

AFFIDAVIT OF SELF-ADJUDICATION
I, JOSE CARLO A. SANTOS, of legal age, married, Filipino Citizen, and with
residence and postal address at 410 Lovebirds St., Phase 4 Countryside Village,
Parañaque City, after having been sworn to in accordance with law, do hereby depose
and state:

1. That I am the legal heir of the deceased CONNIE A. SANTOS who died on July
26, 2021 at Parañaque City;

2. That the Deceased died intestate without leaving any Last Will and Testament
and without any outstanding debts;

3. That the Deceased left the following shares of stock wit;

MERALCO/ROCKWELL
STOCK NO. NO. OF SHARES
DDA 552135 101 SHARES
DDA 153302 200 SHARES
DDA 235811 100 SHARES
DDA 393871 90 SHARES
DDA 514668 117 SHARES
DDB 250097 35 SHARES
DDB 206312 27 SHARES
DDB 148017 30 SHARES
DDB 099806 20 SHARES
DDB 088421 40 SHARES
DDB 287357 30 SHARES
MER 0661919 60 SHARES
MER 0661920 18 SHARES
SC NO. 039093 563 SHARES
SC NO. 039092 1882 SHARES

4. Pursuant to Section 1 of Rule 74 of the revised Rules of Court of the

Philippines, I hereby adjudicate unto myself the above-described property/ies
means of this Affidavit;

IN WITNESS WHEREOF, I have hereunto set my hand this 3 rd day of December

2021, in the City of Parañaque, Philippines.

JOSE CARLO A. SANTOS

Affiant

SUBSCRIBED AND SWORN to before me, this 3rd day of December 2021 in City
of Parañaque, Philippines. Affiant exhibited to me his: Driver’s License – N03-01-
314131.

Notary Public
Doc. No. _______
Page No. _______
Book No. _______
Series of 2021.