REPUBLIC OF THE PHILIPPINES)

QUEZON CITY, METRO MANILA ) S.S.

x---------------------------------------x

AFFIDAVIT OF SURVIVING LEGAL HEIRS

WE, OFELYN F. VELEZ and FRANKLIN F. VELEZ, JR., both of
legal age, Filipinos and residents of No. 39 San Isidro St., Santol, Quezon
City, after being duly sworn to in accordance with law, hereby depose and
state:
1.
That we are the surviving children of Franklin P. Velez who
died on December 5, 2013 in Quezon City due to Cardiopulmonary Arrest
and his deceased spouse Ofelia F. Velez;
2.
That as evidence of our legal relation to the deceased,
photocopies of our Certificate of Live Births are herein attached; and
3.
That we are executing this affidavit in good faith to attest to
the truth that there is no other heir or heirs except for the above-named
heirs of the said deceased spouses and for whatever legal purposes it may
serve.
IN WITNESS WHEREOF, we have hereunto set our hands this 12 th
day of December, 2013 in Quezon City, Philippines.

_______________________________
Affiant

_______________________________
Affiant

BEFORE ME, personally appeared:

Name

CTC Number

Date/Place Issued

OFELYN F. VELEZ
FRANKLIN F. VELEZ, JR.
Known to me and to me known to be the same persons who
executed the foregoing instrument and acknowledged to me that the same
is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL, on the date and place first above
written.

Notary Public
Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.