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______________________
Affiant
SIGNED IN THE PRESENCE OF
___________________________
_________________________
ACKNOWLEDGEMENT
Republic of the Philippines)
Cagayan de Oro City
)
BEFORE ME, a Notary Public for and in City of Cagayan de Oro, personally
appeared ________________ with Drivers License no. ___________________, known
to me and to me known to be the same person who executed the foregoing instrument
and acknowledged to me that the same are their free and voluntary act and deed.
WITNESS MY HAND AND SEAL, this ________________ at
___________________.