REPUBLIC OF THE PHILIPPINES)

____________________________ ) S.S.

AFFIDAVIT OF HEIRSHIP

I, _____, of legal age, Filipino citizen, married and a resident of ________, after being
sworn into in accordance with law, hereby depose and state that –

1. I am the sole surviving child of _______, who died on ______;

2. I am attaching herewith copies of the following documents as evidence of my

legal relation to the aforesaid deceased: (a) my Certificate of Live Birth; (b) Certificate of Death
of _____; (c) Certification from the Office of the Local Civil Registrar of________;

3. I am executing this affidavit in good faith to attest to the truth that there is
no other heir or heirs except for the afore-stated heir of the said deceased _______ and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

____________________, in the _____.

Affiant

SUBSCRIBED AND SWORN to before me, this _____ at ________, affiant exhibiting
to me his _______bearing his photograph and signature as competent evidence of his identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2022.