REPUBLIC OF THE PHILIPPINES )

PARANAQUE CITY ) S.S.

AFFIDAVIT

I, JUAN DELA CRUZ, Filipino citizen, of legal age with

address at 123 Paranaque City, having been sworn in accordance
with law, hereby depose and state that:

1. I executed an Affidavit of Self-Adjudication of the Estate

of the Deceased Maria Clara;

2. My civil status in the Affidavit of Self-Adjudication of the

Estate of the Deceased Maria Clara was inadvertently omitted;

3. My civil status is single;

4. I am executing this affidavit to attest to the truth of the

foregoing and for whatever legal purpose it may serve.

AFFIANTS FURTHER SAYETH NAUGHT.

JUAN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN TO before me this 7th day of

January 2020 at Paranaque City, affiant exhibiting to me the
foregoing competent evidence of identity

Doc. No. ____;

Page No. ____;
Book No. ___;
Series of 2020.