Republic of the Philippines)

C i t y of Davao ) s. s.
x--------------------------------x

AFFIDAVIT OF SERVICE

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

________________________________, Davao City, Philippines. and
______________________, after having been sworn to in accordance with law depose and
state that:

On___________________, I caused the service of the copies of the SUMMONS, VERIFIED

COMPLAINTS and its attachments in relation to the case of Municipal Trial Court in Cities 11 th
Judicial Region, Branch 1, Davao City. _________________________________________

By B By Personal Service:

Name of Respondent Received by: ________________________

Address Position: ____________________________
Date and Time: _______________________

IN WITNESS WHEREOF, I have hereunto set my hand this _____________________

in Davao City, Philippines.

____________________________
Affiant

SUBSCRIBED AND SWORN to before me this _____________________ in Davao

City, Philippines, by the affiant who exhibited to his credentials above-indicated.

Doc. No. ________;

Page No. ;
Book No. _______;
Series of 2 0 2 3