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  • Self Adjudication-Yakult Dealer - Rosbero

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    Michelle Ricaza-Acosta
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    AFFIDAVIT of SELF-ADJUDICATION I, __________, of legal age, Filipino and a resident of ___________________________ hereby depose and state: 1. That I am the daughter of the late ______________; that my mother died on August 30, 2010 in _____________________; 3. That my said mother left no debts; 4. That I hereby adjudicate unto myself the entire benefit; 5. That I execute this affidavit to attest to

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    AFFIDAVIT of SELF-ADJUDICATION I, __________, of legal age, Filipino and a resident of ___________________________ hereby depose and state: 1. That I am the daughter of the late ______________; that my mother died on August 30, 2010 in _____________________; 3. That my said mother left no debts; 4. That I hereby adjudicate unto myself the entire benefit; 5. That I execute this affidavit to attest to

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    Self Adjudication-Yakult Dealer - Rosbero

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    Michelle Ricaza-Acosta
    AFFIDAVIT of SELF-ADJUDICATION I, __________, of legal age, Filipino and a resident of ___________________________ hereby depose and state: 1. That I am the daughter of the late ______________; that my mother died on August 30, 2010 in _____________________; 3. That my said mother left no debts; 4. That I hereby adjudicate unto myself the entire benefit; 5. That I execute this affidavit to attest to

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    REPUBLIC OF THE PHILIPPINES) CITY OF MANDALUYONG, MM ) S.S.

    AFFIDAVIT OF SELF-ADJUDICATION I, __________, of legal age, Filipino and a resident of ___________________________, after being duly sworn according to law hereby depose and state: 1. 2. That I am the daughter of the late ______________; That my mother died on August 30, 2010 in _____________________;

    3. That my said mother left an estate of a ___________________________ from March 5, 1996 to August 10, 2010; 4. That my said mother left no debts; 5. That I hereby adjudicate unto myself the entire benefit and I further declare that I am entitled to claim the survivor benefits due the dependent survivor of my mother; 6. That I declare the above under threat of perjury; 7. That I execute this affidavit to attest to the truth of the foregoing and for whatever legal purposes this may serve. City of Mandaluyong, September 7, 2010.

    SUBSCRIBED AND SWORN to before me this 7th day of September 2010 at ______________________________. Doc. No. Page No. Book No. Series of 2010

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