I, ________________, of legal age, with office address at __________________________________, after having been sworn to in accordance with law hereby depose and state that:

 1. ]

 2. ]    STATE THE FACTS!

 3.]

 4.   I herein attest to the truthfulness of the foregoing facts.
 

 IN WITNESS WHEREOF, I hereby affix my signature this ___ day of __________2000 in Makati City.
 
 
 

                                                                                                                       _______________________
                                                                                                                                           Affiant
 
 

 SUBSCRIBED AND SWORN to before me, a Notary Public, this ___ day of  ____________ 2000 at Makati City, affiant exhibited to me his Residence Certificate issued on ______________ at ______________.
 

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Series of 2000.