IN WITNESS WHEREOF, I affix my signature on this

____________________ at ____________________, Philippines.

(NAME
OF
PETITIONER)
Petitioner

THE

ATTESTATION
I hereby attest that I was the one who conducted the
examination of witness (NAME OF THE PETITIONER), at my
aforementioned office in Unit 205 ACRE Building, No. 137 Malakas
Street, Central, 1100 Quezon City on 15 August 2016. I have
faithfully recorded or caused to be recorded the questions from
Filipino to English. I asked and the corresponding answers that the
witness gave. Neither I nor any other person then present or
assisting him/her coached the witness regarding his/her answers.
IN WITNESS WHEREOF, I affix my signature on this
____________________ at ____________________, Philippines.

(COUNSEL DETAILS)
Subscribed and sworn to before me on this
_________________ at ________________ Philippines, affiants exhibited
to me their competent evidence and identity bearing their
photograph and signature.
Doc. No. _____
Page No. _____
Book No. _____
Series of 2016.
Copy furnished:
(by personal/registered mail/private courier)
(PARTIES AND ADDRESS)

(PROOF OF SERVICE)

EXPLANATION OF SERVICE
Copies of the Judicial Affidavit of (NAME OF THE
PETITIONER) were served to the parties by registered
mail/private courier due to time and distance constraints and for
lack of personnel for personal filing/service.
(NAME OF THE COUNSEL)