REPUBLIC OF THE PHILIPPINES )

PASIG CITY ) S.S.

AFFIDAVIT OF CIVIL STATUS

We, ABRILINA A. MANDAP, widow, DELIA A. RICO, married to Sigfred Rico,
REGGIE A. TESORERO, married to Amado B. Tesorero, HILDA A. RELEVO, married to
Apolonio E. Revelo, and AINIE A. WUANI, married to Anrio Wuani, all of legal ages, all
Filipino citizens, and all residents at LT Extension, Brgy. San Gabriel, Teresa, Rizal, after having
been duly sworn to in accordance with the law, do hereby depose and state:

1. That we are the DONEES in the AFFIDAVIT OF SELF-ADJUDICATION

WITH WAIVER OF RIGHTS, executed on May 18, 2023 at Pasig City, entered
in the Notarial Registry of Atty. Leticia M. Amon, docketed as Doc No. 298, Page
No. 60, Book No. LXV, Series of 2023, over a parcel of land covered by
TRANSFER CERTIFICATE OF TITLE NO. M-102641 containing an area of
FOUR HUNDRED FIFTY (450) SQUARE METERS, situated in the
Municipality of Teresa, Rizal;

2. That in that said AFFIDAVIT OF SELF-ADJUDICATION WITH WAIVER OF

RIGHTS, our civil status was married and the name of our spouses are not
indicated;

3. That we hereby manifest that I, ABRILINA A. MANDAP was widow already, I,

DELIA A. RICO was married to Sigfred Rico, I, REGGIE A. TESORERO was
married to Amado B. Tesorero, I, HILDA A. RELEVO was married to
Apolonio E. Revelo, and I, AINIE A. WUANI was married to Anrio Wuani;

4. That we are executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this ______ day of _______,
2023 at Pasig City, Philippines.

ABRILINA A. MANDAP DELIA A. RICO

AFFIANT AFFIANT

REGGIE A. TESORERO HILDA A. RELEVO

AFFIANT AFFIANT

AINIE A. WUANI
AFFIANT

SUBSCRIBED AND SWORN to before me this _____ day of ________, 2023 at Pasig
City.

Doc No. ______;

Page No. ______;
Book No.______;
Series of 2023