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DELOS REYES, MILES R.

SUCCESSION

AFFIDAVIT OF SELF ADJUDICATION

KNOW ALL MEN BY THESE PRESENTS:

THAT I, LAURENCIA DELOS REYES, widow of the late JOHNNY DELOS


REYES JR., of legal age, Filipino citizen, and residents of BRGY. STA BRIGIDA,
MANSALAY, ORIENTAL MINDORO, hereby freely and spontaneously declares and
makes manifest that:

I am the surviving spouse of the late JOHNNY DELOS REYES JR., who died on
03 Novemeber 2006 at BRGY. STA BRIGIDA, MANSALAY, ORIENTAL
MINDORO. The latter left no known debts and obligations that have remained unpaid
or unsettled, leaving real and personal property, the gross value of which is PHP
10,000,000, and that I hereby adjudicate unto myself said benefits/claims;

IN WITNESS WHEREOF, I have hereunto affixed my signature this day of 05


November 2007 at Oriental Mindoro, Philippines.

LAURENCIA DELOS REYES


Affiant
Postal ID No. 1234567

Signed in the presence of:

HERMENIA RAGASA RESTY RAMOS

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF ORIENTAL MINDORO ) S.S

BEFORE ME, a Notary Public for and in the PROVINCE OF ORIENTAL


MINDORO this November 05, 2007 personally appeared the above-name known to me
to be the same person who executed the foregoing Adjudication, and that she executed
the same voluntarily with her own act and deed.

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

ATTY. KRISKA R. ANTIOJO


NOTARY PUBLIC
Carebi Village, Angono Rizal
Contact No. 02-8118990
IBP No. 9111189 / 01-15-2014 / Makati City
PTR No. 8212135 / 01-15-2014/ Makati City
Roll of Attorney’s No. 80527
MCLE Compliance No. V-0054010

Doc. No. 3;
Page No. 4;
Book No. I;
Series of 2007

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