REPUBLIC OF THE PHILIPPINES)

CITY/MUN. OF _____________ ) S.S.

x-----------------------------------x

AFFIDAVIT OF HEIRSHIP

WE, ________________________, ______________________,

____________________, and ____________________, all of legal age,
Filipinos and residents of ________________________________, after
being duly sworn to in accordance with law, depose and state THAT:

1. We are the surviving children of _____________________ who died on

_______________ in ________________ and his deceased spouse
__________________;

2. That our parents were survived by the following children/heirs:

Full Names of Children/Heirs Dates of Birth

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

3. As evidence of our legal relation to the deceased, photocopies of our birth

certificatesare herein attached; and

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

IN WITNESS WHEREOF, we have hereunto set our hands

this ___________________ in Makati City, Metro Manila, Philippines.

____________________ ____________________
Affiant Affiant
SSS ID No. _____________ SSS ID No. _____________
 ____________________ ____________________
Affiant Affiant
SSS ID No. _____________ SSS ID No. _____________

SUBCRIBED AND SWORN TO before me

this ___________________ in _________________, Philippines, affiants
exhibiting to me their SSS Identification Cards as Competent Evidence of
Identity (CEI).

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2013.