SWORN STATEMENT

I, ___________, of legal age, the _________________ of ___________________. with

office address at _______________________, depose and state under oath:

1. I am the [ ] applicant
[  ] authorized officer of applicant
[ ] agent/authorized representative of applicant

for the registration of the mark “____”, with Application No. (no application number yet/
filed simultaneously with the application).

2. The total assets of the applicant do not exceed Php100 Million.

______________________________
NAME

SUBSCRIBED AND SWORN to before me this _________, the affiant exhibiting to me

his Land Transportation Office ID No, ________ with expiry date ________.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2020.