CERTIFICATION

This is to certify that, I, _______, representative of ____________ as

owner, have the authority to issue herein certification for and in behalf of the
above-cited business;

It is hereby further certified that the name/s listed hereunder comprises the
complete list of all employee/s for said Center located at Cabaguio, Davao City;

This certification is being issued as part of the requirements for the issuance
of business or mayor’s permit of the above-cited business;

The following are the employees with their respective positions or job
descriptions, to wit:

NAMES POSITIONS/JOB DESCRIPTION

1.

Given this ___________ at ____________, Philippines.

Affiant
_____________

SUBSCRIBED AND SWORN TO before me this ____________ at

_________, Philippines.

Doc. No.: _______;

Page No.: _______;
Book No.:_______;
Series of ________.