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__________________________
Lessee
ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES
)
PROVINCE OF __________________ ) S.S.
MUNICIPALITY OF _______________)
BEFORE ME, a Notary Public in and for the Province of _______________,
Municipality of _______________ on this day personally appeared:
Name
____________________
_______________
____________; _______________
____________________
_______________
____________; _______________
____________________
_______________
____________; _______________
____________________
_______________
____________; _______________
____________________
_______________
____________; _______________
known to me and to me known to be the same person who executed the foregoing
instrument and who acknowledged to me that the same is their own free and voluntary act
and deed and that of the corporation they represent.
WITNESS MY HAND AND SEAL this _th day of ____, 20__ at ________________.
ATTY _________________________________
COMMISSION NO. _______________________
NOTARY PUBLIC for _____________________
UNTIL DECEMBER 31, 20__
OFFICE: ________________________________________
ROLL NO. ________ ADMMITTED AT BAR: ___________
IBP NO. ________ ; __/__/__ ; _________________
PTR NO ________ ; __/__/__ ; _________________
MCLE COMPLIANCE No. __________; __________