Republic of the Philippines

__________________

)
) S.S.
ACKNOWLEDGEMENT

BEFORE ME, this _____ of _____________ 201_ in ____________ City,

personally appeared, the above-named persons with their Identification
Cards as indicated below their name and signature, known to me to be the
same persons who executed the foregoing instrument, consisting of ____ (_)
pages, including this page whereon this acknowledgement is written, and
acknowledged that they executed the same to be their free and voluntary
act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal,
this ______ day of _____________ 201__ at the place first above written.
Doc. No. ____
Page No. ____
Book No. ____
Series of 201_

NOTARY PUBLIC