8/18/2019 sample Affidavit of Self-Adjudication by Sole Heir

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REPUBLIC OF THE PHILIPPINES )CITY OF ______________________ ) S.S.

AFFIDAVIT OF SELF-ADJUDICATION

I, [full name] , of legal age, Filipino, [civil status] and a re iden! of [address] af!er "a#ing $een d%l& 'orn !o in a((ordan(e 'i!" la', depo e and !a!e

*. T"a! I a+ !"e [state capacity as legal heir, i.e., only child/widow/remaining parent] of [name of deceased] -e(ea ed) '"o died 'i!"o%! an& la ! 'ill and !e !a+en! on [date] in[City, Province] a e#iden(ed $& "i "er -ea!" Cer!ifi(a!e i %ed $& !"e Ci!& of [specify]"ere!o a!!a("ed a Annex “A” and +ade an in!egral par! of !"i /ffida#i!0

1. T"a! a! !"e !i+e "i "er dea!", !"e -e(ea ed "ad no de$! , lia$ili!ie or o$liga!ion !o

an& per on , agen(& or in !i!%!ion0

2. T"a! !"e onl& proper!& ie lef! $& !"e -e(ea ed are

[state nature and description of properties][attach supporting documents as Annexes]

3. T"a! p%r %an! !o R%le 43, Se(. * of !"e R%le of Co%r!, I "ere$& ad5%di(a!e %n!o +& elf !"e a$o#e6de (ri$ed Proper!& ie $& +ean of !"i /ffida#i! and "ere$& file !"e a+e'i!" !"eRegi !er of -eed of [specify] Ci!& 'i!" !"e re7%e ! !"a! !"e aid ad5%di(a!ion $e+ade effe(!i#e 'i!"o%! 5%di(ial pro(eeding a pre (ri$ed $& !"e afore+en!ioned pro#i ion

of !"e R%le of Co%r!.IN WITNESS WHEREOF , I "a#e "ere%n!o e! +& "and !"i ____ da& of [month][year] in [specify] Ci!&, [Province] , P"ilippine .

[name and signature]/ffian!

SUBCRIBED AND SWORN TO $efore +e !"i ___ !" da& of [month] [year] in specify] Ci!&, [Province] , P"ilippine , affian! e8"i$i!ing !o +e "i "er [competent evidence of identity] i %ed in[place of issue] on [date of issue].

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