REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SURIGAO DEL SUR) S.S.

CITY OF TANDAG)

AFFIDAVIT OF SELF-ADJUDICATION
WITH DEED OF ABSOLUTE SALE
I, DIOSDADO G. DINZO, of legal age, married to Carmen H. Dinzo and a resident of
Magobawok, Bayabas, Surigao del Sur, Philippines, after having been sworn to in accordance
with law, hereby depose and say:

1. That I am the only son of the late DEODOR DINZO (deceased), and a surviving heir-
grandson of the late MARIANO DINZO who died intestate in Bayabas, Surigao del Sur,
Philippines on ______________;

2. That the said deceased left a parcel of land situated at Poblacion, Bayabas, Surigao del
Sur, herein more particularly described as;

“A parcel of land identified as Lot No. 98, Pls-872, covered by Tax

Declaration No. 08-02-0002-00179 and Original Certificate of Title No.
6737, measuring THREE THOUSAND FOUR HUNDRED FORTY
ONE (3,441) Square Meters located at Poblacion, Bayabas, Surigao del
Sur”

3. That the said deceased left no debts, nor any LAST WILL or TESTAMENT;

4. That pursuant to Rule 74, Section 1 of the Rules of Court, I hereby adjudicate unto
myself the above-described parcel of land by means of this affidavit and hereby files the same
with the Municipal Assessors Office in Cortes, Surigao del Sur with the request, that the said
adjudication be made effective without judicial proceedings as prescribed by the aforementioned
Rules of Court.
DEED OF ABSOLUTE SALE

NOW THEREFORE, for and in consideration of the sum of THIRTY FIVE

THOUSAND (P35,000.00) PESOS, in hand paid in full to the entire satisfaction of the HEIR-
VENDOR, receipt of which is hereby acknowledged from the VENDEE ISIDRO V.
LOZADA, of legal age, married to Madelyn v. lozada, and a resident of Bayabas, Surigao del
Sur, by these presents, I, HEIR-VENDOR hereby SELL, TRANSFER, and CONVEY by way
of absolute sale unto the said VENDEE of the above-described parcel of land identified as Lot
No. 98, Pls-872, measuring 3,441 Square Meters, free from all liens and encumbrances;

That I am executing the foregoing instrument in order to apprise the proper authorities
concerned thereto;

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____________ at

Tandag City, Surigao del Sur, Philippines.

DIOSDADO G. DINZO ISIDRO V. LOZADA

Affiant/Heir-Vendor Vendee
____________________ PDL # L09-04-000626

With marital consent to:

 CARMEN H. DINZO MADELYN V. LOZADA
Vendor/spouse Vendee/spouse

Signed in the Presence of:

1. ______________________ 2. ________________________

SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and in the
Province of Surigao del Sur, this ______ day of ____________, in Tandag City, Surigao del Sur,
the affiants personally appeared and affixed their signature together with their ID’s as proof of
their identity.

Doc No ___
Page No ___
Book No ___
Series of 2021.

ACKNOWLEDGMENT RECEIPT
This is to acknowledge receipt of the amount of THIRTY FIVE
THOUSAND (₱35,000.00) PESOS from the VENDEE ISIDRO V. LOZADA as
purchase payment for a certain parcel of land measuring 3,441 Square Meters,
identified as Lot No. 98, Pls-872 and covered by Tax Declaration No.08-02-
0002-00179 and Original Certificate of Title No. 6737, located at Poblacion,
Bayabas, Surigao del Sur.

Tandag City, Surigao del Sur. ________________,

DIOSDADO G. DINZO
Heir-Vendor
__________________________

With marital consent to:

CARMEN H. DINZO
Vendor/spouse

ACKNOWLEDGMENT RECEIPT
This is to acknowledge receipt of the amount of THIRTY FIVE
THOUSAND (₱35,000.00) PESOS from the VENDEE ISIDRO V. LOZADA as
purchase payment for a certain parcel of land measuring 3,441 Square Meters,
identified as Lot No. 98, Pls-872 and covered by Tax Declaration No.08-02-
0002-00179 and Original Certificate of Title No. 6737, located at Poblacion,
Bayabas, Surigao del Sur.

Tandag City, Surigao del Sur. ________________,

DIOSDADO G. DINZO
Heir-Vendor
__________________________

With marital consent to:

CARMEN H. DINZO
Vendor/spouse