REPUBLIC OF THE PHILIPPINES)

CITY OF SAN PABLO) S.S

AFFIDAVIT OF SURVIVING LEGAL HEIR

I, JUANA DELA CRUZ, of legal age, single, Filipino, and a resident of San Pablo City, Laguna,
after having been duly sworn to in accordance with the law, depose and state:

That I am the only surviving child of the late JUAN DELA CRUZ who died on May 11, 2021 at
Naga, Camarines Sur.

That I am executing this affidavit to attest to the truth and veracity of the foregoing facts, and for
all legal intents and purposes that it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of September 2021 at San
Pablo City, Laguna.

JUANA DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me this 6th day of September 2021 in San Pablo City,
Laguna, affiant having personally shown to me her identification card with Passport No. ____________,
as proof of her identity.