AFFIDAVIT OF OWNERSHIP

I, ____________________ A of legal age and currently residing at

_______________________________ after being duly sworn to in accordance with law,
do hereby depose and say.

1. That I am the lawful receiver of the package from

__________________________with declare value of
________________.

2. That it was send thru DHL Waybill __________

3. That said items were sent for personal use only and not for commercial
use nor for resale.

4. That I am willing to pay duties and taxes.

5. That I am executing this affidavit to attest the truth of the foregoing

facts and for whatever legal intent and purposes it may serve.

In Witness Whereof, I have signed this affidavit on the ____ day of _________, 2021.

Receiver Name
Affiant

Subscribed and Sworn before this Philippines.

Doc. No._____
Page No._____
Book No.____
Series of _____