REPUBLIC OF THE PHILIPPINES )

Province of____________________) S.S.

City/Municipality of______________)
x---------------------------------------x
AFFIDAVIT OF PUBLICATION
I, ________________(name of affiant)____________, Filipino, of legal age, [single]/[married to
_________(name of spouse)_________], and a resident of ___________________(address of
affiant)_______________, after having been duly sworn in accordance with law, hereby depose
and state:
1. That I am the Classified Ads Manager of the ________(name of
newspaper)_____________, publisher of the which is being published daily in English, of
general
circulation
with
editorial
and
business
address
at
__________________________________;
2. That at the order of _____________, Extrajudicial Settlement of Estate of the late
_____________________ dated ________________ was published in this newspaper in
its _________ issue(s) of __________________;
IN WITNESS WHEREOF, I have hereunto affixed my signature this ___th day of __________,
20___ at _____________, Philippines.
_________________________________
(Signature of Affiant over Printed Name)

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for

_________(City/Province)____________ this ____th day of ____________ 20___.
Affiant personally came and appeared with _____________(Competent Evidence of
Identity)______ issued by the _________(Government Agency)______ on ___(date)__
at ________(place)_________, bearing his photograph and signature, known to me as the
same person who personally signed the foregoing instrument before me and avowed
under penalty of law to the whole truth of the contents of said instrument.

Doc. No. ____

Page No. ____
Book No. ____
Series of 20__

Atty ___________________________________________
Notary Public
Commission Serial No. ____________________________
Notary Public for _______(Province/City)______________
Until December 31, 20__
Office: ______________(address)____________________
Roll No. __________
IBP Lifetime Roll No. _________; __/__/__ ; _(Province)_
PTR No. _________ ; __/__/__ ; _(Province)_
MCLE Compliance Cert. No. __________; __/__/__

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Note: Issued by a newspaper after the publication of a legal notice in its pages.