REPUBLIC OF THE PHILIPPINES)

In the City of Davao . . . . . ) S.S.

AFFIDAVIT OF ACKNOWLEGEMENT
PROMISSSORY NOTE

I, ​, of legal age, Filipino and a resident of # 450, J.P. Quijano Street,

Poblacion 1, Oroquieta City, after being sworn in accordance with law depose and say:

1. That I am the father of Grace Leopoldo ;

2. That I am an employee of Misamis Occidental Provincial Hospital;

3. That my daughter Grace Leopoldo , while working at Goldfinch Lending

Investor Inc. , Tagum City branch, was able to misappropriate to herself an
amount of ONE HUNDRED THIRTEEN THOUSAND PESOS (
Php113,000.00 ) , to the damage and prejudice of the company;

4. That my daughter misappropriated the above-mentioned amount while

working as a cashier at Goldfinch, Tagum City ;

5. That said misappropriation was acknowledged to me personally by my

daughter in front of the manager Armand D. Japus on July 19, 2004;

6. That in view of the same, I promise in behalf of my daughter to pay to

Goldfinch Lending Investor Inc., the amount of ONE HUNDRED THIRTEEN
THOUSAND PESOS ( Php113,000.00 ) in installment basis at FIVE
THOUSAND PESOS ( Php 5,000.00 ) a month;

7. That payment shall be made through the savings account of Goldfinch Lending
Investor Inc., Philippine National Bank, Matina , Davao City, branch;

8. That I hereby declare in all good faith the truthfulness of the following
declarations and that I execute this promissory note without malice or fraud
on my part;

9. That I am executing this affidavit to attest to the truth of the foregoing facts
and for whatever legal purpose this may serve.

IN WITNESS WHEREOF​, I have hereunto set my hand this July 19, 2004 at
Davao City, Philippines.

(Affiant)

SUBSCRIBED AND SWORN to before me this July 19, 2004 in Davao City,
Philippines by affiant who exhibited to me his community tax certificate with no.
20365014 issued on 01-29-04 at Oroquieta City.

Doc. No.
Page No.
Book No.
Series of 2004