ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES }
Province of ____________________} S.c.
Municipality of _________________}
BEFORE ME, this ____ day of _______________, 20__, in the
Municipality of __________________, Province of ______________,
Philippines, personally appeared _____________________, with
Residence Certificate no. ___________, issued at ______________,
____________, on ____, ___________, 20__, known to me to be the
same person who executed the foregoing instrument, and he
acknowledged top me that the same is his free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and
affixed my notarial seal, the day, year, and place above written.
NOTARY PUBLIC
PTR No. __________
IBP No. ______
Roll No. ______
Until ____, ___________, 20__
Doc. No. ____
Page No. ____
Book No. ____
Series of ____