REPUBLIC OF THE PHILIPPINES)

DONE: IN THE CITY OF BAGUIO) SS.

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

AFFIDAVIT OF KINSHIP

I, ______________________, of legal age, married/single, ___________

citizen, and with residence address at _________________________________
hereby declares and state under oath that:

1. I am the next of kin of __________________________ who died on

________________ at ___________________;

2. I am the __________________ and nearest surviving kin of the

deceased document owner;

3. No personal representative has been appointed for the decedents

estate and no application for such appointment is pending in any
court;

4. I am executing this affidavit to attest to the truthfulness of the

foregoing statements and for purposes of requesting for a copy of his
____________________;

IN WITNESS WHEREOF, I have hereunto set my hand this

______________________, in the City of Baguio, Philippines.

______________________
Affiant
ID No.: ___________________

SUBSCRIBED AND SWORN to before me this _____________________ in

the City of Baguio, Philippines. Affiant exhibited to me her valid identification.