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(TO BE HANDWRITTEN)
MARIBEL M. DE DIOS
Parents/Guardian
Joseph Ivan Mari M. De Dios 393, Villarama Street, Marungko, Angat, Bulacan
Pangalan ng Anak at Kumpletong Tirahan
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES
City of Malolos, S.S.
Province of Bulacan
are known to me to be the same persons who executed the foregoing document and
acknowledged to me that the same is their own free act and voluntary deed.
IN WITNESSWHERE OF, I hereunto sign this document and affix my seal of office
on date and place aforementioned.
NOTARY PUBLIC
Until_________
Doc. No:_________________
Page No.:__________________
Book No.:_________________
Series of 20___
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