Affidavit of Legal Heirs (for Claiming Benefits)

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REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF [CITY/MUNICIPALITY] ) S.S.

AFFIDAVIT OF LEGAL HEIRS

We, the undersigned, all of legal age, Filipino, after having been duly sworn in accordance with law, depose and state that:

1. [FULL NAME OF THE DECEASED], Filipino, of legal age, [CIVIL STATUS], with last residence at [ADDRESS] (the “Deceased”), died on [DATE OF DEATH] at [PLACE OF DEATH], as shown by the attached death certificate (Annex “A”);

2. The Deceased died [WITHOUT A WILL (INTESTATE) / AND TO OUR KNOWLEDGE LEFT NO WILL];

3. At the time of death the Deceased was [MARRIED TO [FULL NAME OF SPOUSE] ON [DATE] / SINGLE / WIDOWED];

4. The Deceased is survived by the following, who are the only legal heirs of the Deceased:

Full name Relationship Date of birth / age Address

[FULL NAME] [SURVIVING SPOUSE] [ ] [ ]

[FULL NAME] [LEGITIMATE CHILD] [ ] [ ]

[FULL NAME] [CHILD] [ ] [ ]

[FULL NAME] [PARENT — only if there are no children] [ ] [ ]

5. There are no other heirs of the Deceased, whether legitimate, illegitimate or adopted, other than those named above;

6. [OPTIONAL — MINOR HEIRS: [NAME OF MINOR] is a minor and is represented by [HIS/HER] [MOTHER/FATHER/GUARDIAN], [FULL NAME];]

7. We are executing this affidavit to support our claim for [THE DEATH / FUNERAL / SURVIVORSHIP BENEFITS / THE MEMBER’S SAVINGS / THE PROCEEDS OF POLICY NO. [NUMBER] / THE FINAL PAY] of the Deceased with [SSS / GSIS / PAG-IBIG FUND / [NAME OF INSURER] / [NAME OF EMPLOYER]];

8. [OPTIONAL: We agree that the benefit be released to [FULL NAME OF HEIR], who will receive it for and on behalf of all of us;]

9. We undertake to hold [THE OFFICE OR COMPANY] free from any claim of any other person who may later prove to be an heir of the Deceased, and to return what we received should it be established that we are not entitled to it;

We are aware that a false statement made under oath may expose us to criminal liability for perjury.

IN WITNESS WHEREOF, we have signed this affidavit this [DAY] day of [MONTH] 2026 at [CITY/MUNICIPALITY], Philippines.

______________________________ [FULL NAME] Affiant — [RELATIONSHIP] ______________________________ [FULL NAME] Affiant — [RELATIONSHIP]

SUBSCRIBED AND SWORN TO before me this [DAY] day of [MONTH] 2026 at [CITY/MUNICIPALITY], Philippines, by the above-named affiants, who each personally appeared before me, signed the foregoing affidavit in my presence, took an oath before me as to the truth of its contents, and exhibited to me the following competent evidence of identity bearing their respective photographs and signatures:

Name Competent Evidence of Identity (type and number) Date / Place of Issue; Expiry

[FULL NAME] [ID TYPE] No. [ID NUMBER] [DATE OF ISSUE] / [PLACE]; [EXPIRY]

Doc. No. ______; Page No. ______; Book No. ______; Series of 2026. __________________________________ [FULL NAME OF NOTARY PUBLIC] Notary Public for [CITY/PROVINCE] Notarial Commission No. [NUMBER] Commission valid until December 31, [YEAR] Roll of Attorneys No. [NUMBER] PTR No. [NUMBER]; [DATE]; [PLACE OF ISSUE] IBP No. [NUMBER]; [DATE]; [CHAPTER] MCLE Compliance No. [NUMBER]; [DATE] Office: [OFFICE ADDRESS OF NOTARY]

NOTES — delete this page before printing

• Purpose: this affidavit supports a claim for benefits. It is not an extrajudicial settlement of the estate (Rules of Court, Rule 74, Sec. 1), which has its own requirements (publication, bond for personal property, registration). It does not transfer land or bank deposits of the estate.

• Who are the heirs is a legal question (Civil Code on succession, e.g. Arts. 887, 960 and following). Benefit laws have their own beneficiary rules — for SSS, dependent spouse and children first, then dependent parents (RA 11199, Sec. 8(k)) — and insurance proceeds go to the beneficiary named in the policy.

• Many offices use their own heirship form (for example Pag-IBIG and SSS). Ask first and use theirs if required.

• Shares of minors: the office may require proof of guardianship, and a court-appointed guardian above certain amounts. Ask the lawyer.

• Notarial act: jurat (2004 Rules on Notarial Practice). Every affiant must appear in person with competent evidence of identity.

• Have this affidavit reviewed by a lawyer before signing.

Field labels in [SQUARE BRACKETS, CAPITALS] must be completed or deleted. Alternatives are separated by a slash. © Layers (layers.md), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Template and deadlines for information only — check your own case with the agency or insurer, and have documents with legal effect reviewed by a lawyer. Not legal advice.

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