I, _____, of legal age, single/married/widow, Filipino citizen, and presently residing at _________, after having been duly sworn to in accordance with law, do hereby depose and say:
That I am the only daughter of PEDRO DELA CRUZ who died without any last will and testament on June 25, 2020 in Makati City as evidenced by his Death Certificate issued by the City of Makati hereto attached as Annex “A” and made an integral part of this Affidavit;
That at the time his death, my father had no debts, liabilities or obligations to any persons, agency or institution;
That the only property he left is a parcel of land consisting of 70 square meters located in J.P. Rizal Street, Makati City more particularly described in TCT No. 9876543 hereto attached as Annex “B” and made an integral part of this Affidavit;
That pursuant to Rule 74, Sec. 1 of the Rules of Court, I hereby adjudicate unto myself the above-described real estate by means of this Affidavit and hereby files the same with the Register of Deed of Makati City with the request that the said adjudication be made effective without judicial proceeding as prescribed by the aforementioned provision of the Rules of Court.
IN WITNESS WHEREOF, I have hereunto set my hand this _ day of __ 20____ in _, __, Philippines.