Rawr Pop Cute Hardcore

The Ex parte Final and executory Revised

(Acknowledgment by an Individual - One-Party Instrument)

REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ______) SS.
x------------------------------------x

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of

_____________, personally appeared _____________ with Community Tax Certificate No.
_____________ issued on _____________ at _____________, personally known to me (or
whom I have identified through competent evidence of identity) and who represented to me that
his/her signature on the foregoing instrument was voluntarily affixed by him/her for the purposes
stated in the instrument and who declared that he/she has executed the foregoing instrument as
his/her free and voluntary act and deed.

This Instrument consists of only ______ (____) page/s, including this page in which this
acknowledgment is written, duly signed by _____________ and his/her instrumental witnesses
on each and every page hereof.

WITNESS MY HAND AND SEAL this _____________ at _____________,

Philippines.

NOTARY PUBLIC

Doc. No. ______;

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