BOOK NO. _______
PAGE NO. _______
NOTARIAL REGISTER of ATTY. ________________________________ of _____________________________, PHILIPPINES for the year ______ under appointment made on
January ______ and expiring on December 31, ______.
DOC.
NO.
NATURE OF INSTRUMENT
NAMES OF
PERSONS
(_______________)
I hereby certify that during the past week (_______________)
(_______________)
( Executing
)
( Swearing
)
(Acknowledging )
Witnesses to
the Signature
DATE
IDENTIFICATION
DOCUMENT
( Executed
)
instruments were ( Sworn to
) Before me.
( Acknowledge )
____________________
Notary Public
REMARKS