REPUBLIC OF THE PHILIPPINES )

Caloocan City ) S.S.

AFFIDAVIT OF SERVICE

I, __________________________, as ___________________________ of,

____________________, with office address at ______________________, after being duly sworn,
depose and say:

That on ________________, 199____, I served a copy of the following pleading/paper by

ordinary/registered mail in accordance with Sections 3 and 5 in relation to Section 10 of Rule 13,
Rules of Court.

Nature of Pleading/Paper

___________________________________

___________________________________

___________________________________

___________________________________

In Case No. _______, entitled ________________________________ by depositing a copy

in the post office. In a sealed envelope, plainly addressed to the party or his attorney at his
office/residence with postage fully prepaid, as evidence (In case of registered mail) by
Registry Receipt No. __________ hereto attached, and with instructions to the postmaster to
return the mail of the sender after ten (10) days if undelivered.

The addressee(s) is/are as follows:

___________________________________

___________________________________

___________________________________

___________________________________

_________________, Manila, Philippines.

SUBSCRIBED AND SWORN to before me this _____ day of _______, 199____, at

_________________, Philippines, affiant exhibiting to me his/her Residence Certificate No.
_________, issued at ___________________ on _______________________.

Officer Administering the Oath