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(ACKNOWLEDGMENT) LEGAL FORMS

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


CITY OF MANILA )

BEFORE ME, this 16th day of June, 2021, in the City of Manila, personally appeared Mr. X with LTO
LICENSE NO. 12344, ISSUED ON: May 25, 2019 in LTO City of Manila, known me to be the same person who
executed the foregoing instrument and acknowledged that the same is his free act and deed.

IN WITNESS WHEREOF, I set unto my hand and seal on the date and place above written.

(Sgd.) ATTY. JUAN DELA CRUZ


Notary Public for Manila
Appointment No. 123
Until December 31, 2021
Roll No. 123456; 5/20/05
IBP No. 13456/ January 1, 2019/ City of Manila
PTR No. 213456/ January 1, 2019/ City of Manila
MCLE NO. I – 0001223; 9/09/2019
MCLE NO. II – 0002345; 9/09/2019

DOC. NO. 34
PAGE NO. 23
BOOK NO. III
SERIES OF 2021

By: Caffeinated Wisdom


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