Heirship With SPA - Template

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REPUBLIC OF THE PHILIPPINES)

CITY OF ____________ ) S. S.

AFFIDAVIT OF HEIRSHIP WITH SPECIAL POWER OF ATTORNEY

WE, ______________________, Filipino, of legal age, widow, and


______________________, Filipino, of legal age, single/annulled and both residents of
_______________________, Philippines, after having duly sworn to in accordance with law,
hereby depose and say:

1. That we are the only compulsory heirs of our late husband/father,


_______________________ of ______________________, Philippines;

2. That __________________ died intestate and without debts on


________________________, at ____________________________, Philippines, leaving behind
us his only compulsory heirs certain Time/Building Fund Deposits at
________________________________ as follows:

Account Name Reference Amount Date of Issue Maturity


OR # Date

3. That we hereby adjudicate unto ourselves the above-mentioned time/building fund


deposit accounts or the money deposited therein;

SPECIAL POWER OF ATTORNEY/AUTHORITY

4. That we, ___________________, Filipino, of legal age, widow, in my capacity as co-


depositor and spouse/heir of _________________, and _______________________, Filipino, of
legal age, single/annulled, in my capacity as only son/heir of _____________________, do
hereby authorize, constitute and appoint our grandson/son _____________________, who is a
co-depositor in the above accounts and grandson of the aforesaid deceased
___________________, Filipino, of legal age, single and a resident of ____________________,
Philippines, to get, claim, receive and withdraw, whatever amount or the entire amount in the
above-mentioned time/building fund deposit accounts, including its interests, and to close the
same time/building fund deposit accounts;

5. That we hereby undertake, warrant and agree to hold said


_______________________________ free and harmless against any claim that may arise as a
result hereof and to indemnify the Cooperative for any expense, damage or loss that it may
sustain by reason thereof;

6. That we execute this affidavit to attest to the foregoing facts and for whatever legal
purposes that this may serve.

IN WITNESS WHEREOF we have hereunto set our hands this


_____________________________ at _________________________, Philippines.

_____________________________

1
Affiant/Heir
Valid ID: _________________________
Issued by/on: ___________________________

________________________
Affiant/ Heir
Valid ID: _________________________
Issued by/on: ___________________________

Signature of Attorney-in-Fact: ___________________________________--


Valid ID: _________________________
Issued by/on: ___________________________

Signed in the presence of:

____________________________ ______________________________

SUBSCRIBED AND SWORN to before me this _______________________ at


___________________________--, Philippines.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2020.

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