(Acknowledgment by an Individual and a Corporation)
REPUBLIC OF THE PHILIPPINES)
CITY/MUNICIPALITY OF______) SS.
BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of_____________,personally appeared _____________with Community Tax Certificate No._____________ issued on_____________at____________(and Tax Identification No. (T.I.N.) _____________), and____________with Community Tax Certificate No. _____________issued on _____________at____________representing to be the__position in the corporation__of__(name of corporation)__with Community Tax Certificate No._____________issued on ____________ at _____________(and Tax Identification No. (T.I.N.)_____________), both known to me and tome known to be the same persons who executed the foregoing instrument which they acknowledged to me as their free and voluntary act and deed, as well as the free and voluntary corporate act and deed of the corporation herein represented, consisting of only_____(____) page/s, including this page in which this Acknowledgement is written, duly signed by them and their instrumental witnesses on each and every page hereof.
WITNESS MY HAND AND SEAL this_____________at _____________, Philippines.
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of _____;