Affidavit of Identity

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Republic of th Philippies]

------------------------------]S.S

AFFIDAVIT OF IDENTITY
I,------------------------------------------------------------------of legal age, Filipino and residing at -----------------------
----------------------------------------------- after being duly sworn in accordance with law, depose and say that:

1. I am a Business Associate of First Vita Plus Marketing Corporation [FVPMC] with B.A. No.---------
2. I am also known under the following names with corresponding Business Associates numbers:

Name .B.A.No.

[a]------------------------------------------- -----------------

[b]------------------------------------------ __________

[C]_________________________ __________

3.The aforementioned names all re3fer to me; therefore all checks representing sales
commissions, rebates and other benefits from First Vita Plus Marketing Corporation (FVPMC)
accruing or due the aforementioned account names and B.A. numbers may be claimed and/
or released to the undersigned.

FURTHER I SAY NONE.

______________________________
Affiant

SUBSCRIBED AND SWORN to before me this ______________ in ___________________


Philippines, affiant exhibiting CTC. NO __________________ issued on _______________________
__________________________at ______________________..

Doc. No.
Page No
Book No.
Series of 2009

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