Page No.

______
JUDICIAL FORM 143, AS AMENDED
PORMULARYONG PANGHUKUMAN BLG. 143
NOTARIAL REGISTER OF _ATTY. JOANNE D. ORGANIS of BULA CAMARINES SUR, Philippines, for the year 2019
REHISTRO NOTARYAL NI _______________________________ ng Lungsod ng _____________________________, Pilipinas, para sa taong ________
Under appointment made on the June 29, 2018 and expiring December 31, 2019
Sa Nombramiento na ginawa noong ika- _____ ng ________, __________ na magtatapos sa Disyembre 31, ___________

ENTRY TITLE/DESCRIPTION OF NAMES & ADDRESSES OF NAMES & ADDRESSES OF COMPETENT EVIDENCE OF DATE & TIME OF TYPE OF NOTARIAL ACT* FEES & O.R. NO. OTHER PLACE OF
NUMBER INSTRUMENT PARTIES WITNESSES IDENTITY NOTARIZATION NOTARIZATION
OTHER THAN OFFICE
OF NOTARY PUBLIC
AND / OR REMARKS

I HEREBY CERTIFY that during the past week _______________ instruments were executed before me
ginawa sa harapan ko
pinatutunayan ko na noong nakaraang lingo _______________ ang mga kasulatang sworn to
pinanumpaan
_______________ acknowledged
tinanggap
DATE: ____________________________________
Petsa ATTY. JOANNE D. ORGANIS
NOTARY PUBLIC
Notaryo Publiko
*whether acknowledgment, oath, jurat, signature witnessing or copy certification