(Jurat for an Individual Affiant)

SUBSCRIBED AND SWORN to before me, this (date), by the Affiant

who is personally known to me (or whom I have identified through
competent evidence of identity) and who exhibited his/her (ID) No. ______
issued at _______ on ________.

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______;

(Joint Affiants)

SUBSCRIBED AND SWORN to before me, this (date), by

__________ who exhibited his/her ID No. _____ issued at ______ on
_______, and by ___________ who exhibited his/her ID No. _____ issued
at ______ on _______, both of whom are personally known to me (or whom
I have identified through competent evidence of identity).

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______;

(Multiple Affiants)

SUBSCRIBED AND SWORN to before me, this (date), by the

following who are personally known to me (or whom I have identified
through competent evidence of identity) and who exhibited to me their
respective identification cards (TIN/CTC) as follows:

Name (TIN/CTC) No. Date/Place of Issue

1. ______________ ____________ ________________

2. ______________ ____________ ________________
3. ______________ ____________ ________________

NOTARY PUBLIC
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of ______;