SAMPLE

AFFIDAVIT OF CAPITAL/SEPARATE PROPERTY

I, ______________________, of legal age, (nationality), married to _________, and

with postal address at ___________, after having duly sworn in accordance with law,
hereby depose and state that:

1. I am an owner of a parcel land described as TCT No. _______ of the Registry

of ________________, known as Lot No. ___, Block No. ____ with a total area of
______________ (_______ sq. meters) (hereinafter, the “Property”) located at
___________________;

2. I inherited the above-described property from my parents by virtue of an

Extrajudicial Settlement of Estate of the Late ______________ dated _____________;

3. Being inherited property, the same forms part of my capital or exclusive

property and does not form part of the community property or conjugal partnership;

4. I am executing this affidavit in order to attest to the truth and for all legal
intents and purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day of

__________________ at ______________________.

______________________________
Affiant

Republic of the Philippines) s.s.

City of Makati )

SUBSCRIBED AND SWORN to before me this _____ day of _________, in

__________________, affiant exhibiting to me his _____________ issued on
_____________ at the _________________.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 20xx.