Form No. 5--Acknowledgement for and in behalf of a Corporation

(Acknowledgment for and in behalf of a Corporation)

REPUBLIC OF THE PHILIPPINES)
CITY/MUNICIPALITY OF ______) SS.

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of _____________ this __date__ personally appeared _____________ 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.) _____________, known to me and to me known to be the same person who executed the foregoing instrument for and in behalf of said corporation, and (he/she) acknowledged to me that the same is the free and voluntary corporate act and deed of __(name of corporation__.

This Instrument consists of only ______ (____) page/s, including this page in which this Acknowledgement is written, duly signed by _____________ and his instrumental witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL this _____________ at _____________, Philippines.

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;

Book No. ______;

Series of ______;