REPUBLIC OF THE PHILIPPINES )

CITY OF MANDAUE ) S.S.

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

AFFIDAVIT OF ADJUDICATION AS SOLE HEIR

I, __________________, of legal age, Filipino, single and a resident

of _________________________, after having been duly sworn to in
accordance with law, depose and state, that:

1. I am the only child and surviving heir of my parents

________________[name] and _________________[name] who
respectively died on ______________[date] and ________________[date]
at ________________[address]; certified copies of their Death Certificates,
Marriage Contract and my Certificate of Live Birth are attached and
respectively marked as Annexes “A”, “B”, “C” and “D”;

2. My deceased parents at the time of death left no last will and testament; and
had no existing debts or obligations of whatever nature to whomsoever;

3. My deceased parents at the time of death left the following described

property/properties:

[list and describe the properties with OCT/TCT No. _____ or Tax Dec. No.
__________, if not registered];

WHEREFORE, as sole heir of ____________________[name of

decedent] I have adjudicated and by these presents adjudicate to myself the
entire estate hereinabove described, subject to the liabilities to creditors,
heirs or any other persons who might have claim against the said estate or
may be prejudiced or deprived of their lawful share in the said estate, for two
(2) years in accordance with the Rules of Court specifically Rule 74, Section
4.

FURTHER, AFFIANT SAYETH NAUGHT.

______________________
Affiant
ID & no. ______
Issued on: ______
Expiry date: ____

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 JURAT

SUBSCRIBED AND SWORN TO before me in ___________, this

____ day of ____________ by the aboved-named affiant, who has
satisfactorily proven to me his identity, to be the same person who presented
and personally signed before me this (state name of document) and attested
that the contents thereof are true and correct; and that he voluntarily
executed the same.

ATTY. CHRISTIAN HERMOGILA ABENIR

A.M. No/Comm. No. ________
Date and place issued
Commission expires on Dec. 31, ____
Roll of Attorneys Number: 76227
IBP No. 207325/May 06, 2022/Cebu City
PTR No. MC1376738/June 01, 2022/Cebu City
MCLE VII Exempt/2020-2021 Bar Passer
7-036 Z Estreras St., Brgy. Pgasabungan Mandaue City
christian.abenir2020@gmail.com
09104533153/09615245263

Doc. No. ______:

Page No. ______:
Book No. _____:
Series of 20____.

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