ACKNOWLEDGMENT

Republic of the Philippines)

City of ______ ) S.S.

BEFORE ME, a Notary Public, for and in the City of ________, this
_____ day of ________ 2013 personally appeared:

Name Identification Card Issued

On/At

_______________ ___________ ___________

_______________ ___________
___________

all known to me to be the same persons who executed the

foregoing instrument and hereby acknowledged to me that the same is their
free and voluntary act and deed.

This instrument consisting of ____ pages, including this page on which

this acknowledgment is written refers to a [type of contract/agreement] and
has been signed by the parties and their witnesses and sealed with my
notarial seal.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2013.