Republic of the Philippines}

Province of _________ } s.s.

City of ________________}

AFFIDAVIT OF HEIRSHIP

I, __________, of legal age, widow, and a resident of Brgy.

_______________, after having been sworn to in accordance with law, do
hereby depose and say:

1. That I _________, is the legitimate wife of deceased____________., a

copy of our Marriage Contract is hereto attached as Annex “A”;

2. That my marriage with the late ___________ produced ____ children,

namely: _______________________;

3. That as proof of our children’s filiation and to prove that said persons
mentioned in paragraph 2 above are the legitimate heirs __________ I am
attaching as Annexes “B”, “C”, “D”, “E”, “F” and “G” their respective birth
certificates showing the name of their father ______________________;

4. That I am attesting to the truthfulness of the foregoing statements.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of

___________________, Philippines.

_____________________
Affiant

SUBSCRIBED and sworn to before me this __ day of ________ in

_________.