Republic of the Philippines

PROVINCE OF

)
) S.S.

ACKNOWLEDGMENT
BEFORE ME, a Notary Public for and in the Province and City of ___, personally
appeared the following together with proof of their identity:
Proof of Identity

valid until

known to me to be the same persons who executed the foregoing instrument which they
acknowledged to me as their free and voluntary act and deed, consisting of two (2) pages
including this page in which this Acknowledgment is written, duly signed by them and their
witnesses.
WITNESS MY HAND AND SEAL this _______________ at ____________,
Philippines.

Doc. No.
Page No.
Book No.
Series of 2014.