1057

Form No. 3
Declaration as to Heirship
I, ... residing at ... do solemnly declare and say as follows :
1. The late Mr. A residing at ... died on or about the ... day of ... in-
testate and leaving behind him an immoveable property situate at ... and
more particularly described in the Schedule hereunder written.
2. I know the family of the said Mr. A and I know personally that the
said A left behind him a widow named ..., two sons named ... and one
daughter named ..... I have been living as a neighbour of the said A and
his family for the last several years and am fully acquainted with that
family. Both the said sons and daughter are major.
3. I understand that the heirs of the said A have agreed to sell the said
property and the intending purchaser wants a confirmation that the said
four persons are the only heirs or next-of-kins of the said Mr. A
4. I, therefore, declare that the said four persons are the only heirs of
the said A and he has no other child or children. I say that what is stated
above is stated truly and conscientiously and knowing ful well that relying
on the said statement and representations the said Purchaser has agreed
to purchase the said property.
THE SCHEDULE ABOVE REFERRED TO
x x x x
Solemnly declared at ... )
on this ... day of ... )
BEFORE ME
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