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That the above-named parties are the surviving spouse and legitimate children,
respectively, of the late: EUSEBIO I. ROSTATA, who died on MARCH 11, 2008 at
SHANNON WEST TEXAS MEMORIAL HOSPITAL, Tom Green, San Angelo, 76903,
Texas, USA as indicated under his Death Certificate No. 01-0233 duly issued by the LCR
Of Tom green county, San Angelo Texas due to Cardiac Arrest Herewith is attached a
copy of the said Death Certificate as ANNEX A;
That the said deceased died intestate without executing any Testament to the best
of their knowledge and information of the parties hereto and the said deceased left no
debts;
That said deceased, at the time of his death he left behind a parcel of lot with
improvements with an area of 202 sq.m. more or less, located at Dau Homesite,
Mabalacat, Pampanga covered under TCT NO. 186628-R;
TCT NO. 186628-R
A parcel of land (Lot-10, Blk-20-1 of the subd., plan (LRC) Psd-202163
being a portion of lot 29-B (LRC) Psd-197421, LRC (GLRC) Rec. No.
11732) situated in the Bo. Dau , Mabalacat, Pampanga x x x x x with an
area of 202 sq.m. more or less x x x
That pursuant to Sec. 1, Rule 74 of the Revised Rules of Court of the Philippines, and the
parties herein being of age, and with full civil capacity to contract, hereby by these
presents agree to divide and adjudicate, as they hereby divide and adjudicate, among
themselves, the above-described real property, in accordance with the provision of the
law in relation to intestate succession. That their respective shares in relation to the
undivided portion of the said lot with an area of 202 square meters only will be
WAIVED Equally to the FAVOR of: JOANNE B. ROSTATA, of legal age, single,
Filipino and a resident of 13174 Saguin St., Dau Homesite, Mabalacat City, Pampanga;
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
and have no claim or demand against each other.
IN WITNESS WHEREOF, I have hereunto set my hand this 4 th day of
September, 2013 at Mabalacat City, Pampanga.
JULIA B. ROSTATA
Surviving Spouse
With Waiver of Rights
REGINA B. ROSTATA,
Surviving daughter
With Waiver of Rights
ROGER B. ROSTATA
Surviving son
With Waiver of Rights
JOANNE B. ROSTATA
Surviving daughter
Represented by:
GLORYDINNE B. ROSTATA
Atty-in-fact
Darren Valenzuela
Dau, Mabt. City
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
MABALACAT CITY, PAMPANGA) S.S.
BEFORE ME, a Notary Public for and in Mabalacat City, Province of Pampanga,
this 4th day of September, 2013, came and appeared, known to me to be the same person
Glorydinne B. Rostata who has satisfactorily proven to her identity through her SSS ID
No. 02-3081419-2; that she is the same person who executed the foregoing instrument
relating to the Extra-Judicial Partition Settlement Among Heirs with Waiver of Rights,
consisting of three (3) pages including the page on which this Acknowledgment is written
and that the same is her free own and voluntary act and deed.
WITNESS MY HAND AND SEAL.