AFFIDAVIT OF ADJUDICATION BY SOLE HEIR OF ESTATE OF DECEASED

PERSON

AFFIDAVIT
REPUBLIC OF THE PHILIPPINES )
CITY OF ____________________ ) S.S.

I, ______________, of legal age, married to ______________________________ (or

single) and now residing at __________________________________________, Philippines,
after having been sworn in accordance with law, depose and say:
1. That I am the only surviving son of____________, who died intestate in the
municipality of _______________, Philippines on _____________________, as evidenced by
Death Certificate issued by the __________________ hereto attached as Annex “A” and made
an integral part of this Affidavit;
2. That said deceased left an estate consisting of a parcel of land measuring
____________ sq.m, located in the municipality of __________________________, and
evidenced by Transfer of Title No.___________ of the Registry of Deeds of ______________;
3. That the said parcel of land is more particularly described as follows:
(Description)
4. That said deceased left no debts;
5. That the net value of said estate is not more than three thousand pesos (P3,000),
and is therefore exempt from the estate and inheritance taxes, as evidenced by a certificate of
exemption issued by the Bureau of Internal Revenue hereto attached as Annex “B” and made an
integral part of this affidavit;
6. That pursuant to Rule 74, Sec. 1 of the Rules of Court, I hereby adjudicate unto
myself the above described real estate by means of this Affidavit and hereby files the same with
the Register of Deeds of _______________________ with the request that said adjudication be
made effective without judicial proceedings as prescribed by the aforementioned Rules of Court.

IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of___________,
2_____, in_____________________, Philippines.

(Signature of Affiant)

JURAT