Note: If the instrument is signed by the President of the corporation and the corporate

seal is affixed by the secretary, the better practice is for both officers to acknowledge its
execution.

REPUBLIC OF THE PHILIPPINES)

__________________________)S.S.

In the City of _____________ this_______ day of _____________ personally appeared

before me ________________ acting for and in behalf of the ____________, of which he is the
President, with his Community Tax Certificate No. _________ issued on ________ at
_____________, known to me and to me known to be the same persons who executed the
foregoing instrument and acknowledged to me that the same is his free act and deed.

IN WITNESS WHEREOF, etc.

Doc. No. _______ Atty. ___________________________

Page No. _______ Notary Public for (place where
commissioned)
Book No. _______ Commission Serial No. _____________
Series of (year) Until Dec. 31, ____________________
Office Address ___________________
Roll of Attorney No.
PTR No.___/Issued at_____/on ______
IBP NO.__________ /date/place issued)