Anda di halaman 1dari 2

REPUBLIC OF THE PHILIPPINES )

CITY OF PASIG ) S.S.

AFFIDAVIT OF CIVIL STATUS

I, FRANCIS GLENN L. YU, Filipino, of legal age, with office address


at 22nd Floor, The Taipan Place, F. Ortigas, Jr. Road, Ortigas Center, Pasig
City, after having been duly sworn to in accordance with law, do hereby
depose and say:

1. That my present civil status is MARRIED;

2. That I married _____________________________, a Filipino citizen,


on 7 October 2000 at ______________________________; and

3. That this affidavit is being executed to attest to the foregoing facts


for the specific purpose of clarifying the doubt regarding my civil
status in the Deed of Donation executed between myself and
Yangxujia Holdings, Inc. dated 9 January 2019.

IN WITNESS WHEREOF, I have hereunto set my hands this ______


day of May 2019 at the City of Pasig, Philippines.

FRANCIS GLENN L. YU
Affiant

Witnesses:
___________________________ _____________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


PASIG CITY ) S.S.

SUBSCRIBED AND SWORN to before me, a Notary Public, this ____


day of May 2019 in Pasig City, personally came and appeared the affiant
with his competent evidence of identification:

NAME IDENTIFICATION DATE & PLACE OF


ISSUE
FRANCIS GLENN L. TIN: 168-604-647 N/A
YU

1
known to me and to me known to be the same person who executed
the foregoing instrument and he personally acknowledged that the same is
his free and voluntary act and deed.

The foregoing instrument related to an Affidavit of Civil Status


consisting of two (2) pages, including the page on which this
acknowledgement is written, and has been signed by the affiant and the
instrumental witnesses and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed


my notarial seal on this _____ day of May 2019, in Pasig City, Philippines.

Doc. No.: ____ NOTARY PUBLIC


Page No.:____
Book No.:____
Series of 2019.

Anda mungkin juga menyukai