BEFORE ME, this_____ day of _________, 2001 in the Municipality of
_________________, Province of _____________, Philippines, personally appeared _______________________ , with Residence Certificate No. _______ issued at ________, on _______________ , and B.I.R. Tax Account No.________ known to me to be the same person who executed the foregoing instrument, and he acknowledged to me that the same is his free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial
seal, the day, year, and place above written.
Notary Public
My Commission expires Dec. 31, 2001
IBP No. ________, 1/2/2001, Pasig City P.T.R. No. ______, 2/2/2001, Pasig City Doc. No. _____; Page No. ____; Book No. _____ Series of 20___