(Acknowledgment by an Individual and a Corporation)

REPUBLIC OF THE PHILIPPINES)
CITY/MUNICIPALITY OF______) SS.
ACKNOWLEDGMENT
BEFORE ME, a Notary Public for and in the
(Province/City/Municipality) of_____________,personally appeared
_____________with Community Tax Certificate No._____________
issued on_____________at____________(and Tax Identification No.
(T.I.N.) _____________), and____________with Community Tax
Certificate No. _____________issued on
_____________at____________representing to be the__position in
the corporation__of__(name of corporation)__with Community Tax
Certificate No._____________issued on ____________ at
_____________(and Tax Identification No. (T.I.N.)_____________),
both known to me and to me known to be the same persons who
executed the foregoing instrument which they acknowledged to me as
their free and voluntary act and deed, as well as the free and
voluntary corporate act and deed of the corporation herein
represented, consisting of only_____(____) page/s, including this
page in which this Acknowledgement is written, duly signed by them
and their instrumental witnesses on each and every page hereof.
WITNESS MY HAND AND SEAL this_____________at _____________,
Philippines.