AFFIDAVIT OF SOLE ADJUDICATION

I, GLICERO INDIC GO, of legal age, Filipino, married to Emilia Edna

Malulot Go, and with postal address at Poblacion, Julita, Leyte, after having been
sworn according to law, depose and say: THAT--1. I am the sole and only surviving heir of decedent CRISPIINA INDIC,
widow, who died intestate on April 18, 1973 in Tacloban City, leaving certain real
property in Julita, Leyte and more particularly described as follows:
PARCEL 1
A parcel of residential land located at Poblacion, Julita, Leyte
under Tax Declaration No. 02-20004-00161 (Year 2003) in the
name of Crispina Indic (deceased) with an area of SIX HUNDRED
SIXTY ONE (661) SQ.M. more or less; assessed at P16,340.00
only, bounded on the North by Flaviano Rivas; on the East by
Fructusa Cayuba; on the South by Del Aqua St; and on the West by
Gloria Pelicaro.
PARCEL 2
A parcel of land (Lot 4108 of the Cadastral Survey of
Burauen), with the improvements thereon, situated in the Barrio of
Julita, Municipalaity of Burauen. Bounded on the NE by Lot No.
4107; on the SE by Calle San Nicolas; on the SW by Lot 4119; and
on the NW by Lot No. 4067 ...containing an area of ONE
HUNDRED AND EIGHTY SEVEN (187) SQ.M. more or less,
covered by TRANSFER CERTIFICATE OF TITLE NO. T-7283 of
the Register of Deeds of the Province of Leyte and registered in the
name of CRISPINA INDIK, and supported by current Tax
Declaration No. 02-2004-00159 (Year 2003)with assessed value of
P23,111.33 only.
PARCEL 3
A parcel of land (Lot No. 4623 of the cadastral survey of
Burauen) with the improvements thereon, situated in the Barrio of
Julita, Municipality of Burauen. Bounded on the NE by Lots Nos.
4632, 4629, 4630 and on the SE by Lots Nos. 4619, 4620 and
4622; on the SW by Lot No. 4624; and on the NW by Lots Nos.
4625, 4626, 4627, 4628 and a barrio road ... containing an area of
TWENTY FOUR THOUSAND NINE HUNDRED AND FIFTY-FIVE
(24,955) SQ.M. more or less, covered by ORIGINAL CERTIFICATE
OF TITLE No. 32530 of the Register of Deeds of the Province of
Leyte, and registered in the names of CRISPINA INDIC (deceased)
and ANATALIA INDIC (deceased) in undivided equal shares, and
supported by current Tax Declaration No. 02-20004-00160 (Year
2003) with assessed value of 27,140.00 only.

2. The decedent has left no known debts or obligations that have

remained unpaid or unsettled; neither has she left any other heirs entitled to
succeed in her estate, except the herein affiant who is her sole surviving
son/child.
WHEREFORE, and invoking the provision of Section 1, Rule 74 of the
Rules of Court, the herein affiant does hereby adjudicate unto himself the entire
estate hereinabove described, subject only to contingent liabilities to creditors,
heirs and other persons who might have been deprived of lawful participation
therein in accordance with Section 4, Rule 74 of the Rules of Court.
FURTHER, AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereto have affixed my
signature this _______________ at Tacloban City, Philippines.
GLICERIO I. GO
Affiant
SIGNED IN THE PRESENCE OF:
_______________

Republic of the Philippines

Province of Leyte
City of Tacloban

_______________

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ACKNOWLEDGMENT
BEFORE ME, a Notary Public for Tacloban City, this ___________ at
Tacloban City personally appeared GLICERIO INDIC GO, exhibiting to me his
CTC
No.
____________
issued
on
________________
at
__________________, known to me to be the same person who executed the
foregoing instrument, and he acknowledged to me that the same is his free act
and deed.
WITNESS MY HAND AND NOTARIAL SEAL.
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Page No. ___
Book No. ___
SERIES OF 2006

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PHILIPPINE CONSULATE GENERAL
CITY AND COUNTY OF HONOLULU
STATE OF HAWAII, U.S.A.

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ACKNOWLEDGMENT
BEFORE ME, ARLENE GONZALES-MACAISA, Counsel of the Republic
of the Philippines in the City and County of Honolulu, HawaiI, U.S.A., duly
commissioned and qualified, personally appeared GLICERIO INDIC GO, on this
_______________________ at Honolulu, Hawaii, to me known and known to me
to be the same person who executed the annexed AFFIDAVIT OF SOLE
ADJUDICATION being informed by me of the contents of the said instrument,
and acknowledged before me that the same is his own free will and deed.
This Consulate General assumes no responsibility for the contents of the
annexed document.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the
seal of the Consulate General of the Republic of the Philippines at Honolulu,
HawaiI, United States of America, this ______________________.

ARLENE GONZALES-MACAISA
Consul
Annexed document is an
Affidavit of Sole Adjudication
Executed by Glicerio Indic Go

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