_____________________________
(Printed Name Over Signature)
WITNESSES:
________________________
_______________________
ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES)
_____________________________ ) SS.
BEFORE ME, a Notary Public, this ____________day of ________________,
personally appeared the following:
Name
(Name of Debtor)
CTC Number
10000000
Date/Place Issued
January 15, 20__ / Manila
IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place above written.
Notary Public