EXTRAJUDICIAL SETTLEMENT OF ESTATE OF DECEASED

PERSON WITH SIMULTANEOUS DONATION

KNOW ALL MEN BY THESE PRESENTS:

This EXTRAJUDICIAL SETTLEMENT OF ESTATE OF A DECEASED PERSON, is

made and entered into by and among the following HEIRS OF , specifically:

1. JEFFERSON Filipino, of legal age, married and a resident of Valencia, Negros

Oriental, herein also referred as Heir-Donor;
2. JACKY Filipino, of legal age, married and a resident of Valencia, Negros Oriental,
also herein referred as Heir-Donor;
3. TERESITa Filipino, of legal age, widow and a resident of Valencia, Negros Oriental
herein referred also as Heir-Donor;

That the late CONSTANTINO who died sometime on __________________ at Valencia,

Negros Oriental, Philippines without any will, leaving behind the above-named persons as his
sole heirs;

That at the time of death of the decedent, he left the following real estate properties
described as follows, to wit:

Lot No. _____ TD No. 2017-18-

A parcel of land designated as Lot No. 3732 with an area of 4,170 square meters more or
less, which is bounded as follows:

North: Lot 37 South: CREEK

East: CREEK West: 37

That the said real estate was purchased from the Hermosila Mapili by virtue of an
Affidavit of Adjudication and Deed of Absolute Sale entered as Doc. No. _______, Page
No.________, Book No.______, Series of 20____ from the notarial registry of Atty.
_______________________;

That no personal properties are involved in this Extrajudicial Settlement;

That to the best knowledge and information of the parties hereto, the said deceased left no
debts;

That a true copy of this extrajudicial settlement and partition of estate of a deceased
person with simultaneous sale shall be published once a week for three (3) consecutive weeks in
a newspaper of general circulation in the Province of Bohol where the property is situated;

WHEREAS, it is to be the best interest of the parties hereto to divide and adjudicate
among themselves, the entire estate extrajudicially, in the form and manner hereinafter set forth;

NOW THEREFORE, for and in consideration of the premises, and invoking the
provisions of Rule 74, Section 1, of the Rules of Court, the parties hereto do by these presents
agree to divide and partition the entire estate above described, adjudicating, as they do hereby
adjudicate, the same to and among themselves in pro indiviso equal shares subject, however, to
the liabilities imposed by Rule 74, Section 4, of the Rules of Court, in favor or any other
possible heirs, creditors, and other persons who might be deprived of their lawful participation in
the estate of the decedent, for a period of two years.

AND WITNESSETH FURTHER:

1
 That FOR AND IN CONSIDERATION of the DONEE’S trust, devotion and affection shown to
the DONOR, and as an act of gratitude and liberality on their part, the DONOR hereby voluntarily
GIVES, TRANSFERS, and CONVEYS by way of donation, unto the said DONEE,
____________________ their heirs and assigns, the above described property, free from all liens and
encumbrances ;

That the DONORS affirm that this donation is not made with intent to deceive their creditors, and
that they have reserved for themselves sufficient funds and property;

That the HEIRS-DONORS hereby warrant valid title to, and peaceful possession of the
property herein relinquished and conveyed, and further declare that the same is free from all liens
and encumbrances of any kind whatsoever;

That the above-described parcel of land is not tenanted nor leased to anybody;

That the HEIRS-Donors hereby warrant valid title to, and peaceful possession of the
property herein relinquished and conveyed, and further declare that the same is free from all liens
and encumbrances of any kind whatsoever;

That the HEIR- DONEE, _____________________ hereby accepts and receives this
donation made in their favor by the DONORS, and hereby manifests their gratefulness for their
generosity.

IN WITNESS WHEREOF, the parties have hereunto set their signatures

______________________ at Tagbilaran City, Bohol, Philippines.

JEFFERSON JACKY
Heir/Donor Heir/Donor
Issued on_____________ Issued on _____________
Issued at _____________ Issued at_________________

TERESITA
Heir/Donor
ID Issued on __________________
ID Issued at __________________

Donation accepted by:

JD
Heir/ Donee
ID Issued on _________________
ID Issued at __________________

Signed in the presence of: ___________________ and _____________________

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LIÑAB I
VICEN

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )

CITY OF TAGBILARAN ) S.S.

BEFORE ME, this ____ day of ____________, 20___, in the City of Tagbilaran, Province of
Bohol, Philippines, personally appeared the abovementioned persons exhibiting to me their
respective competent evidence of identity as above-shown, all known to me and to me known to
be the same persons who executed the foregoing instrument and they acknowledged to me that
the same are their free act and voluntary deed.
This Extra-judicial Settlement of Estate of Deceased Person with Simultaneous Donation
consisting of three (3) pages including the page on which this acknowledgment is written and is
signed on each and every page by the parties hereto and their corresponding witnesses.

WITNESS MY HAND AND NOTARIAL SEAL on the date and place first above-
written.

Doc. No. ______

Page No. ______
Book No. ______
Series of 2022