Republic of the Philippines)

__________________________ )S.S.

ACKNOWLEDGMENT

BEFORE ME a notary public for and in the _________________________ this __ day

of _____ 2019 personally appeared _______________________ who exhibited to me
his/her competent evidence of identity required under A.M. No. 02-8-13-SC as amended
which is shown directly below his/her name and signature, who is known to me and to me
known to be the same person who executed and signed the foregoing
“__________________” and acknowledged before me that the same is his/her own free
and voluntary act and deed. Further, I CERTIFY That I personally examined
__________________ who affirmed that s/he understood the contents thereof.

Doc. No.
Page No.
Book No.
Series of 2019