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DEED OF EXTRAJUDICIAL SETTLEMENT OF THE ESTATE OF THE DECEASED

xxx WITH DEED OF ASSIGNMENT IN FAVOR OF xxx

KNOW ALL MEN BY THESE PRESENTS:

WE,

(1) xxx, 75 years old (born on February 8, 1942), widow, naturalized American citizen,
and residing at ______________;
(2) xxx, 48 years old (born on November 3, 1971), married, naturalized American citizen,
and residing at ______________________;
(3) xxx, single, 43 years old (born on June 24, 1973), naturalized American citizen, and
residing at ____________________;
(4) xxx, married, 42 years old (born on January 2, 1975), naturalized American citizen,
and residing at _____________________;
(5) xxx, 40 years old, married, naturalized American citizen, and residing at
_____________________________ ; and
(6) xxx, 39 years old (born on October 25, 1977), married, naturalized American citizen,
and residing at ________________________, under oath, depose, state, covenant and
stipulate:

1. That the undersigned are the legal heirs of the deceased xxx, who died at the age of
74 (born on December 13, 1941) on October 12, 2016 in _______________, as per a
copy of his Death Certificate of the said deceased issued on October 26, 2016 by the
County of Los Angeles of Department of Public Health, California, with State File No. xxx,
Local Registration No. xxx marked as Annex “A” hereof, for reference.

2. That the legitimate spouse/widow (legal heir) of the deceased xxx is the undersigned
xxx;

3. That the legitimate children (legal heirs) of the deceased xxx are the undersigned
(a) xxx,
(b) xxx
(c) xxx,
(d) xxx, and
(e) xxx;

4. That the estate left by the deceased xxx consists of his accumulated Philippine Social
Security System (SSS) pensions, under SSS No. xxxx, deposited in the BANK OF xxx
(xxx), xxx Branch, xxx City, Philippines, with Savings Account No. xxxx, amounting to
One Hundred Seventy thousand and Fifty Pesos (P170,050.00), more or less;

5. That, by way of EXTRAJUDICIAL SETTLEMENT of the estate of the deceased xxx,


his undersigned legal heirs hereby EQUALLY PARTITION among themselves his estate,
pursuant to the Civil Code of the Philippines and the Rules of Special Proceedings of the
Revised Rules of Court of the Philippines;

6. That the undersigned legitimate children of the deceased xxx , namely, (a) xxx, (b) xxx
(c) xxx, (d) xxx, and (e) xxx, hereby ASSIGN, TRANSFER AND CONVEY the entirety of
their respective individual shares/legitimes in favor of their legitimate mother xxx
(legitimate widow of the deceased);

7. That the estate of the deceased is not subject to any existing lien, encumbrance, lis
pendens, garnishment, attachment, injunction, execution, or any debt or obligation.

8. That the undersigned legal heirs of the said deceased hereby undertake to pay the
necessary taxes, fees, charges, assessments or expenses, if any, that may be due and
owing to the Philippine Government or any of its instrumentalities or agencies, the Bank
of xxx (xxx), or any party or entity entitled thereto under existing Philippine laws;

9. That, as required by the Rules of Evidence of the Revised Rules of Court of the
Philippines, this Deed of Extrajudicial Settlement is acknowledged and authenticated by
the proper consular officer of the Philippine Consulate in Los Angeles, California, USA
with jurisdiction over the respective residences of the undersigned legal heirs of the said
decedent and with jurisdiction over the place of death of the said decedent;

10. That we undertake to comply with all the rules, regulations, procedures and
requirements of the Bank of xxx (xxx), the Philippine Social Security System (SSS), the
Philippine Bureau of Internal Revenue (BIR), and other concerned public or private
agencies or offices to give full legal effect to the provisions of this Deed of Extrajudicial
Settlement;

NOTHING FOLLOWS.

__________, California, USA, _________, 2017.