Acknowledgment by Individuals - Two-Party Instrument

(Acknowledgment by Individuals - Two-Party Instrument)

REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ______) SS.

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of

_____________, personally appeared _____________ with Community Tax Certificate
No. _____________ issued on _____________ at _____________ (and Tax Identification
No. (T.I.N.) _____________), and _____________ with Community Tax Certificate No.
_____________ issued on _____________ at _____________ (and Tax Identification No.
(T.I.N.) _____________), both known to me and to me known to be the same persons
who executed the foregoing instrument which they acknowledged to me to be their
free and voluntary act and deed, consisting of only ______ (____) page/s,
including this page in which this Acknowledgement is written, duly signed by them
and their instrumental witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL this _____________ at _____________, Philippines.

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;

Book No. ______;

Series of ______;