Republic of the Philippines)

Quezon City ) S.S.

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AFFIDAVIT

I, Jack E. Rivera, Filipino, of legal age, single, and a resident of, Zamboanga Sibugay, Philippines, after
being sworn to in accordance with law, depose and state:

1. That I am a bonafide member of Soldier’s Elite Force, presently assigned at Eastern Command,
Quezon City;

2. That my signature might have changed/ altered by passing of time and therefore I request the Agency
concerned to treat my signature as per the records maintained with the agency as cancelled;

3. That the specimen signature given below be taken as cancelled:

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4. That my specimen signature below be taken on record:

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5. That I am executing this Affidavit to attest to the truth of the foregoing and for whatever legal purpose
it may serve.

IN WITNESS HEREOF, I have hereunto affixed my signature this ______________ in ______________,

Philippines.

Jack E. Rivera
Affiant

SUBSCRIBED AND SWORN to before me this _____________in ______________,

Philippines, affiant exhibited his ______ with number ______issued at _____ main office.

NOTARY