REPUBLIC OF THE PHILIPPINES)
CITY OF MALOLOS, BULACAN)S.S.
AFFIDAVIT OF CIVIL STATUS OF PARTIES
I, ATTY. TEODULO E. CRUZ, of legal age, married, Filipino, of legal age with
residence and post-office and post-office address at Sta. Cruz, Santa Maria, Bulacan,
having been duly sworn to in accordance with law, hereby depose and say;
1. That, I had notarized a particular document, denominated as “PARTITION
AGREEMENT” under Doc. No. 468; Page No.95; Book No. 06; Series of 2022
dated March 16, 2022;
2. That, the civil status of the parties thereon were not specifically designated as such;
3. That for clarity, the civil status of each and every party as follow;
JOSEFINA ROXAS-TEODORO, widow;
ADRIANO T. ROXAS married to FLORDELIZA M. ROXAS;
ROBERTO T. ROXAS married to TERESITA DR. ROXAS
ALFREDO T. ROXAS married to EMMA P. ROXAS;
MAGDALENA ROXAS-MANIO, widow;
SIMPLICIA ROXAS-MAK married to TOBY MAK;
4. That I am executing this affidavit to attest to the truth and the veracity of the above-
foregoing facts and for all legal intents and purposes this may serve best.
IN WITNESS WHEREOF, I have hereunto set my signature this _____ day of
_____________, 2022 in the City of Malolos, Bulacan.
ATTY. TEODULO E. CRUZ
Affiant
SUBCRIBED AND SWORN to before me this ____ day of Malolos City, Bulacan.
Affiant personally known to me and/or identified through competent evidence of identity as
the person who executed and signed the document in my presence and exhibited to me his
Roll No. 38635;
Doc. No.____;
Page No.___;
Book No.___;
Series of 2022