Affidavit of Surviving Legal Heirs

COA affidavit of surviving legal heirs

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We ____________________, ____________________, ____________________, of legal age,
____________________, ____________________, Filipino and resident of ________________,
_______________, ________________, _________________, Philippines, after having been duly sworn
to in accordance with the law, depose, and state that:
I, ____________________ is the surviving spouse of the deceased___________________ who died
on ________________ at ________________________.
That we, _____________________, _____________________, _____________________, and
____________________, are the only children of ____________________ and __________________.
That we are executing this affidavit to attest to the truth and veracity of the foregoing facts and
for all legal intents and purpose that it may serve.
IN WITNESS WHEREOF, we have hereunto set our hands ___ day of ________________, 20 ___ at
______________.

___________________
Affiant

____________________
Affiant

(State birthday and relationship to the deceased)

(State birthday and relationship to the deceased)

____________________
Affiant

_____________________
Affiant

(State birthday and relationship to the deceased)

(State birthday and relationship to the deceased)

____________________
Affiant
(State birthday and relationship to the deceased)

SUBSCRIBE AND SWORN to me before this ____ day of ___________, at ______________ on
_________, affiant exhibited to me his/her Government issued ID __________No._________________
issued at __________ on ____________.
Doc. No.
Page No.
Book No.
Series of

_________
_________
_________
_________

NOTARY PUBLIC