Republic of the Philippines)

City of Cagayan de Oro )Sc.

AFFIDAVIT of SELF-ADJUDICATION

I, JOHN DELA CRUZ, of legal age, Filipino, married and a resident of Opol,
Misamis Oriental, after having been duly sworn in accordance with law hereby depose
and state:

1. That I am the SOLE and ONLY HEIR of JUAN DELA CRUZ, who died on
July 25, 2009, in Opol, Misamis Oriental; and PAULITA C. DELA CRUZ, who
died on March 17, 1987, in Opol, Misamis Oriental.

2. That JUAN DELA CRUZ and PAULITA C. DELA CRUZ died without any
debts and without any wills.

3. That the decedents left a parcel of land in Opol, Misamis Oriental, evidenced
by Original Certificate of Title No. E-4282.

4. That considering JUAN DELA CRUZ and PAULITA C. DELA CRUZ have no
heirs, other than myself, I am adjudicating unto myself the entire estate of
JUAN DELA CRUZ and PAULITA C. DELA CRUZ.

5. That this self-adjudication is pursuant to Section 1, Rule 74 of the Rules of

Court.

6. That finally, I execute this affidavit to establish the truth to the foregoing
statements and for whatever purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on January 31, 2023 in the
City of Cagayan de Oro.

JOHN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me on January 31, 2023 in the City of

Cagayan de Oro. Affiant exhibited to me his Philippine Passport numbered P123456789
valid until Dec. 31, 2030.

CHESTER C. CASTAÑOS
Notary Public (for El Salvador to Binuangan, including
Doc. No. _____ CDO
Page No. _____ NC 2022-78 (CDO) valid until 12/31/23
Book No. _____ PTR OR No. 123456 A / 1-3-2023
Series of 2023. IBP OR No. 789876 1-3-2023
Roll No. 54917
MCLE Comp. No. VII-0012345 / 4-14-2019
Tel No. 0917 712 0321/Address: Yacapin St.