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Republic of the Philippines)

Done in the City of Baguio) s.s.

AFFIDAVIT OF SELF-ADJUDICATION

I, ELVIE COLAS KILEY, of legal age, widow, Filipino citizen, with

residence and postal address at No. 30 Tacay Rd., Guisad, Baguio City,

Philippines after having been duly sworn to in accordance with law hereby

depose and states:

1.That I am the only surviving spouse of the late FRANKLIN STEVE Y.KILEY who died intestate on December 20, 2009 at Pines Hospital,

Baguio City (copy of his death certificate is hereto attached as Annex

A and made an integral part hereof), leaving a two (2) unit taxi,

however, only one (1) unit is registered in his name and the other one

(1) is not yet transferred to him and more particularly described as

follows:

UTILITY VEHICLE REGISTERED IN THE NAME OF MY LATE HUSBAND

MAKE: TOYOTA

SERIAL/CHASSIS NO: LF82-6005584

MOTOR NO: 2L-5437580

PLATE NO: AYR 523

MV FILE NO: 1308-00000277634SERIES: REVO

MODEL: 2004

COLOR: WHITE

CR NO: 5612136-5

UTILITY VEHICLE REGISTERED IN THE NAME OF FLORENCE L. KILEY

MAKE: TOYOTA

SERIAL/CHASSIS NO: LF82 6000845MOTOR NO: 2L 9782155

PLATE NO: AYP 498

MV FILE NO: 1380 00000261270

SERIES: REVO

MODEL: 2003

COLOR: WHITE

CR NO: 9219952-0

(For complete technical descriptions please see attached photocopy of

CR No. 5612136-5 and 9219952-0 and marked as Annex B and

C, respectively and made an integral part hereof.)

2.That at the time of his death, said decedent left no will and obligation;

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3.That it is to the best of my interest I hereto adjudicate unto myself thesaid two (2) unit taxi and subsequently will be transferred in my

name;

4.That this instrument is published in a local newspaper of generalcirculation for three (3) consecutive weeks in compliance with its

proper and due registration;

5. I am executing this affidavit to attest to the veracity and truthfulnessof the foregoing statements and for all legal intents and purposes it

may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_______ day of __________________, 2012 at Baguio City, Philippines.

ELVIE COLAS KILEY

Affiant

WITNESSES: __________________ __________________

Republic of the Philippines)

Done: City of Baguio ) S.S.

ACKNOWLEDGEMENT

Before me a notary public for and in the City of Baguio, this ______day of

______________, 2012, personally came and appeared ELVIE COLAS KILEY

personally known to me and presented to me her __________________________

an integrally complete instrument for identification and she acknowledged to me that

the same is her own free act and deed.

I further certify that the foregoing instrument, consisting of Two (2) pages,

including the acknowledgment, relate to AFFIDAVIT OF SELF-ADJUDICATION

pertaining to two (2) unit of taxi, signed by the affiant thereto and her witnesses.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc. No. _________;

Page No. ________;

Book No. ________;

Series of 2012.