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Form No. 3--Declaration of Heirship Self Adjudication of Estate of Deceased Person

(Declaration of Heirship Self Adjudication of Estate of Deceased Person)

Republic of the Philippines)
Province of ____________________)S.S.
City/Municipality of _____________)
x - - - - - - - - - - - - - - x


I, _____________, Filipino, of legal age, (single / married / widow), and a resident of _____________, Philippines, after being sworn in accordance with law, depose and state:

1. That I am the only child and sole heir of _____________ who died intestate on _____________ at _____________;

2. That said deceased left a certain parcel of land covered by Transfer Certificate of Title No. _____________ and more particularly described as follows:

(Technical Description of Property)

3.That said deceased left no debts, nor any Last Will and Testament;


4.That pursuant to Sec. 1 of Rule 74 of the Revised Rules of Court of the Philippines, I hereby adjudicate unto myself the above-described parcel of land, and the improvements found and standing thereon, and I hereby request the Register of Deeds to issue a new Transfer Certificate of Title in my name;

5.That the above-described parcel of land does not come under the operation of the Comprehensive Agrarian Reform Program.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ in _____________, Philippines.




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