Republic of the Philippines )

_____________, ________________)S.S.

AFFIDAVIT OF SERVICE

I, ___________________, of legal age, single, Filipino, and a resident of

_______________________, ______________, after having been duly sworn to in
accordance with law, do hereby depose and state:

1. That on __________________, at about __________, I went to the residence

of __________________ located in _____________, ________________ to
personally serve a document denominated as ____________________ dated
_________________;

2. That when I reached the aforesaid place, I met and personally served the said
_______________ to ______________________ herself;

3. That to confirm and recognize his receipt thereof, ______________ affixed his
signature over his handwritten name at the bottom portion of a copy of the said
document in my presence;

4. That I have executed the foregoing Affidavit to attest to the truth hereof and
for whatever legal intents and purposes it may duly serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of

_____________, ______ at __________________, ________________.

___________________________
Affiant

SUBSCRIBED AND SWORN to before me this ___ day of

____________, _____ at the ____________, ____________, affiant exhibited to
me his _____________________________, as competent proof of his identity.

Doc. No.__________
Page No._________
Book No._________
Series of 2022