Republic of the Philippines )

________________________ ) S.S.

AFFIDAVIT

I, __________________, of legal age and a resident of

___________________________________, after having been duly sworn
in accordance with law hereby depose and state:
1. I have entered into a Service Agreement with 51Talk English
International Limited (“company”) to be a Service Provider
and have read and clearly understood all the terms and
conditions of the same.
2. That through one of the provisions in the Service
Agreement, I have confirmed and agreed to be solely
responsible for providing accurate details of my preferred
remittance system for duly authorized collection and/or
receipt of my service fees.
3. That due to time and distance constraints, particularly
the difficulty of going to Hong Kong to engage my preferred
remittance company, I hereby authorize any employee, staff
or any duly authorized personnel of the company to
personally receive and remit directly my service fees to
any of the company’s duly accredited medium of remittance.
4. That I further authorize any employee, staff or any duly
authorized personnel of the company to submit any and all
documents that may be required by the aforesaid remittance
agency in connection with the foregoing purpose, and to pay
all corresponding fees and charges, if any, via deduction
and/or withholding of a portion of my service fees.
5. That by doing so, I am holding the company harmless and
free from any and all claims, demands, suits, causes of
action, damages, costs, expenses, attorney’s fees, and
obligations of any nature whatsoever arising from or in
connection with the provisions of this affidavit unless
there is inexplicable gross negligence or willful and
malicious intent on the part of company.
6. That I am executing this Affidavit to attest to the truth
of the foregoing and for all legal intents and purposes the
same may be used.

AFFIANT FURTHER SAYETH NAUGHT.

 In witness hereof, I have hereunto affixed my signature this
____day of ___________________________, in the City of
_____________________________.

__________________________________
Affiant

SUBSCRIBED AND SWORN to before me on ___________________ in

________________, affiant exhibiting to me _______________________
issued on ________________ and valid ________________________ who
was identified by me through competent evidence of identity to be
the same person who presented the instrument and signed such
instrument in my presence and who took an oath before me as such
to said instrument.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2015.