AFFIDAVIT OF OWNERSHIP

I, , of legal age and currently residing at ,

after being duly sworn to in accordance with law, do hereby depose
and say.

1. That I am the lawful receiver of the package containing personal items from
___________________________

2. That it was send thru DHL with reference no. _______________

3. That said items were sent for my personal use only and not for commercial
use nor for resale.

4. That I am willing to pay duties and taxes

5. That I am executing this affidavit to attest the truth of the foregoing facts and
for whatever legal intent and purposes it may serve.

In Witness Whereof, I have signed this affidavit on the day of ____________

__________________________
AFFIANT

Subscribed and sworn before me this _______ day of _________________

__________, Philippines.

Doc. No._____
Page No.2
Book No.____
Series of 2019