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IN WITNESS WHEREOF, I have hereunto set my hand this

_____________ at ______________________, Philippines.

Affiant

SUBSCRIBED AND SWORN TO before me this


_________________ at _________________________, affiant
exhibiting me his/ her:

Name Type of ID ID No.

NOTARY PUBLIC

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2018.

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