(Declaration of Heirship / Extra-Judicial Settlement of Estate with Waiver of Share)

EXTRA-JUDICIAL SETTLEMENT OF ESTATE

WITH WAIVER OF SHARE

KNOW ALL MEN BY THESE PRESENTS:

We, _____________, widow of _____________, of legal age, Filipino and a resident of

_____________ and _____________, _____________, _____________, who are all of legal
ages, (single / married / widow), and all residents of _____________, Philippines, do hereby
declare as follows:

1. That the above-named parties are the widow and legitimate children and the sole and
compulsory heirs of the deceased _____________ who died on _____________ at
_____________;

2. That the decedent died intestate, without leaving any Last Will or Testament and without
leaving any debts or accounts whatsoever;

3. That the decedent left the following parcel of land which is conjugal and owned in
common with his wife, the herein _____________;

(Technical Description of Property)

4. That pursuant to Section 1, Rule 74 of the Revised Rules of Court of the Philippines, and
the parties herein being all of age and full civil capacity, they have agreed to divide as
they do hereby divide and adjudicate, the real properties, above-described as follows:
_________________________;

5. That we hereby affirm that we have executed the this instrument out of our own free will
without force, intimidation or violence upon our person, and that we have hereby
received our just and proper share and have no more claim or demand against each other
in connection with the adjudication of the above-described parcel of land;

6. That I _____________, for my part and for and in consideration of the sum of
_____________ (P_____________), Philippine Currency, to me in hand paid by my
herein above-named children to wit, _____________, _____________ and
_____________, I do hereby SELL, TRANSFER and CONVEY unto my said children
all my rights, interest and participation in the above described parcel of land, do hereby
WAIVE all my rights, interest and participation in the above-described parcel of land, in
favor of all my above-named children, share and share alike, pro indiviso.

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

_____________, Philippines.

WIDOW CHILD

CHILD CHILD

SIGNED IN THE PRESENCE OF:

__________________ __________________

(ACKNOWLEDGMENT)