ESCHEAT

(Caption and Title)

PETITION

COME NOW the Provincial Fiscal of _________________ and in behalf of the

municipality of __________________, unto this Honorable Court, respectfully avers:

1. That ________________, an American citizen, and resident of the municipality

of ________________________, province of _________________, dies intestate in the
said municipality on _________________________;

2. That at the time of his death, he left personal and real property in the
municipality of ___________________, province of ________________; to wit:
___________________;

3. That he left no heir or heirs or persons who by law are entitled to inherit his
personal and real property.

WHEREFORE, it is respectfully prayed that, upon due notice and hearing, and
after the payment of his just debts and charges, the estate of the deceased
________________ be declared escheated in favor of the Government in accordance with
law.

____________, this _________ day of __________________, 200__.

________________________
(Provincial Fiscal)