REPUBLIC OF THE PHILIPPINES )

CITY OF __________________ ) SS.

x---------------------x

VERIFICATION

I, _(name of authorized representative)_ , of legal age, Filipino and a resident of

____________________________________________ , after having been duly sworn to in
accordance with law hereby depose and state that:

1. I am the duly authorized representative of PHOENIX MEMORIAL CHAPEL

AND CREMATORY INC., in the above-entitled case against
__________________________________________;

2. I have caused the preparation of the instant _________________ to be filed with the
________________;

3. I have read and understood its contents and found them to be true and correct based
on my personal knowledge and authentic records.

4. The pleading is not filed to harass, cause unnecessary delay, or needlessly increase
the cost of litigation; and

5. The factual allegations therein have evidentiary support after reasonable

opportunity for discovery.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ____ 20__ in
the City of _____________ , Philippines

_________________
Affiant

SUBSCRIBED AND SWORN TO before me this ______ day of _____ 20___ in the
City of _____________, Philippines, affiant exhibiting to me her ____________ with ID No.
_____________ issued on _________________.

Doc. No. ______ ;

Page No. ______ ;
Book No. ______ ;
Series of 20__