REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF SAN JUAN ) S.S.

PROVINCE OF ILOCOS SUR )
x-----------------------------------x

AFFIDAVIT OF HEIRSHIP

WE, ________________________, ______________________, _______________, all of

legal age, and minors _____________________, _____________________,
________________, ________________________, all Filipinos and residents of Barangay
Galing, San Juan, Ilocos Sur, Philippines, after being duly sworn to in accordance with law,
depose and state THAT:

1. We are the surviving legal heirs of the late OFW PENG GALAPONG who died on 15
December 2016 due to plane crash;

2. That the late OFW Peng Galapong was survived by her parents, namely: Spouses
____________; by her husband Mr. Ear Galapong; and by the four (4) minor children, as
follows:

Full Names of Children/Heirs Dates of Birth

1. ______________________ ___________________
2. ______________________ ___________________
3. ______________________ ___________________
4. ______________________ ___________________

3. Our legal relation to the deceased, can be best supported by her Death Certificate, the
Marriage Certificate, and the Birth Certificates of her four (4) minor children;

4. We are executing this affidavit in good faith to attest to truth that there is no other heir or heirs
except for the above-named heirs of the said deceased OFW Peng Galapong and for whatever
legal purpose it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this ______________ at

San Juan, Ilocos Sur, Philippines.

Affiant Affiant Affiant

Affiant Affiant Affiant

Affiant

SUBCRIBED AND SWORN TO before me this ______________ in Municipality of

San Juan, Province of Ilocos Sur, Philippines, the affiants are personally known to me.