CALVELO RUSTIA, both of legal ages, Filipino Citizens, with residence at Manila, Philippines, after having been duly sworn to in accordance with law, jointly depose and say:
1. That our father, ____________ (deceased) and
____________________ , the mother of SERVACIA CREER owned in common a parcel of land more particularly described as follows;
"A parcel of land designated as Lot 793-pt, situated at
___________________ with an area of _____________ square meters, more or less, bounded in the North by Lot#793-pt.-P. Ambay; on the South by Lot # 789; on the East by Brgy. Road and on the West by Lot # 793-pt. - E. Sacapano. Said land is declared in the name of MANOLITO TUPAZ under ARP/TD No. 017-0108-0109 for the year 1994.
2. That in a Deed of Adjudication with Waiver of Rights executed
by us before Notary Public Higino c. Macabales dated June 10, 2004 and and recorded in his Notarial Book as Doc. No. 296; Page No. 60; book No. XIV; Series of 2004, we have adjudicated unto ourselves the above described parcel of land;
3. That recognizing the ownership of ____________________ over
the aforementioned parcel of land declared in the name of ___________________ , we, Heirs of _____________________ do hereby waive, renounce, quitclaim and return any and all rights, interest and participation whatsoever over the above- mentioned parcel of land in favor of _________________ , her heirs, successors and assigns now and in perpetuity; 4. That we do not interpose nor object to the issuance of new Tax Declaration in the name of ___________________________ ; 5. That we hereby acknowledged any act of ownership of said _________________ over the above described parcel of land;
6. That we are executing this affidavit freely and voluntarily fully
aware of the consequences of this document;
IN WITNESS WHEREOF, we have hereunto set our hands this at -
Report of the Decision of the Supreme Court of the United States, and the Opinions of the Judges Thereof, in the Case of Dred Scott versus John F.A. Sandford
December Term, 1856.