Adjucation With Waiver of Share

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EEXTRAJUDICIAL SETTLEMENT OF

EESTATE OF FRANCISCO TAGAL WITH |


WAIVER OF SHARE

KNOW ALL MEN BY THESE PRESENTS:

WE, C, E, R and L all of legal ages, Filipino Citizens, all married except L who
is a widow, and all residents Pasay City except Leonida Tagal who is a resident of Vigan
City:

WITNESSETH:

That we are the widow and legitimate children and sole heirs of the deceased F,
who died on __________________ at ___________________ , copy of his death
certificate is hereto attached as Annex "A" and made an integral part of this document;

That said deceased died intestate, without Will or Testament and without any
outstanding debts in favor of any person or entity;

That the deceased left bank accounts with outstanding balances with the Land
Bank of the Philippines – Vigan Branch, with Bank Savings Account Nos.
_________________ relative to his PVAO and monthly pension benefits;

That pursuant to Sec. 1, Rule 74 of the Revised Rules of Court of the Philippines,
and the parties herein being all of age, they have agreed to divide as they do hereby
divide and adjudicate, the immediately abovementioned account which is considered part
of the estate of Francisco Tagal in the following manner:

“That we, C, E, and R hereby waive our rights, interest and participation
in the aforementioned accounts in favor of L”

That they hereby affirm that they have executed the foregoing instrument out of
their own voluntary free will without force, intimidation or violence upon their persons,
that they have hereby received their just and proper share and have no claim or demand
against each other.

IN WITNESS WHEREOF, WE have hereunto set our hands this ___th day of
_________________, 2010 at __________________________, Philippines.

C E
Adjudicatee Adjudicatee
___________________ _____________________
___________________ _____________________
___________________ _____________________

R L
Adjudicatee Adjudicatee
___________________ _____________________
___________________ _____________________
___________________ _____________________

Page Two
X ----------------------------------------- X

SIGNED IN THE PRESENCE OF:

__________________ ___________________

Republic of the Philippines )


________________________)S.S
________________________)

BEFORE ME, a Notary Public for and in the


_____________________________, personally came and appeared C,R,R and L with
sufficient evidence of identification appearing immediately below their respective names
and signatures, known to me and to me known to be the same persons who executed the
foregoing document of which they acknowledged and sworn to me that the same is their
free ac and voluntary deed.

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

Doc. No. _______;


Page No. _______;
Book No. ______;
Series of 2010

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