REPUBLIC OF THE PHILIPPINES) PAGE ONE

[ADDRESS];) S.S.

LAST WILL AND TESTAMENT

Of

[NAME]

KNOW ALL MEN BY THESE PRESENTS:

I, [NAME], of legal age, single, a native of Philippines, having been born on the
[BDAY & ADDRESS], being of sound and disposing mind and memory, and not acting
under undue influence, violence, fraud, or intimidation of whatever kind, do by these
presents declare this to my Last Will and Testament which I have caused to be written in
English, the language which is known to me. And I hereby declare that:

1. I desire that my remains be buried according to the rites of the Roman

Catholic Church and with dignity suitable to my circumstances;
2. I designate [NAME], as the sole executor and administrator of this Last Will
and Testament, and in her incapacity, I name and designate [NAME]as
her substitute.

IN WITNESS WHEREOF, I have hereunto set my hand this 5th day of August, 2017, in
Las Pinas City, Philippines.

[NAME]
 PAGE TWO

ATTESTATION CLAUSE

We, the undersigned attesting witnesses, whose residences are stated opposite
our respective names, do hereby certify: That the testator, [NAME], has published unto
us the foregoing Will consisting of three pages numbered correlatively in letters on the
upper part of each page, as his Last Will and Testament and has signed the same and
every page thereof, on the left margin, in our joint presence and we, in turn, at his request
have witnessed and signed the same and every page thereof, on the left margin, in the
presence of the testator and in the presence of each and all of us.

[NAME] [ADDRESS];

[NAME] [ADDRESS];

[NAME] [ADDRESS];

JOINT ACKNOWLEDGMENT

BEFORE ME, Notary Public for and in the City of Cagayan de Oro, Philippines, this
13th day of March, 2010, personally appeared:

The testator, [NAME], with Community Tax Certificate No. 1234567, issued on
August 21, 2017 at [ADDRESS];

Witness, [NAME]with Community Tax Certificate No. 7654321, issued on August 21,
2017 at [ADDRESS];

Witness, [NAME], with Community Tax Certificate No. 24681011, issued on August
21, 2017 at [ADDRESS];

Witness, [NAME], with Community Tax Certificate No. 135791113, issued on August
21, 2017 at [ADDRESS];

all known to me to be the same persons who signed the foregoing Will, the first as
testator and the last three as instrumental witnesses, and they respectively
acknowledged to me that they signed the same as their own free act and deed.
 PAGE THREE

This Will consist of three pages, including the page on which this acknowledgment
is written, and has been signed on the left margin of each and every page thereof by
the testator and his witnesses, and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place
above written

[NAME]
Notary Public for Las Pinas City
Door 118, 18th Street, Pulang Lupa Uno,
Las Pinas City
Appointment No. 18 until May 18, 2017
Roll of Attorneys No. 18
PTR No. 192345, issued on June
18, 2009 at Las Pinas City
IBP No. 101010; issued on June
18, 2009, Las Pinas City Chapter
Serial No. of Commission 1818664

Doc. No. 18;

Page No. 18;
Book No. 18;
Series of 2017.