JURAT
(Affiant personally known to NP)
SUBSCRIBED AND SWORN to before me in the City of Calbayog this ________
day of November 20___ by JUAN DELA CRUZ, personally known to me, who is the
same person who personally signed before me the foregoing affidavit and
acknowledged that he executed the same.
Doc No. ___;
Page No.___;
Book No.___;
Series of 20__.
MARIA CATHERINE G. SALURIO
Notary Public
Until December 31, 2022
PTR No. ; Calbayog, January , 2021
Roll of Attorneys’ No. 75345
IBP No.
MCLE Compliance No. New
With Valid ID (Affiant identified by the Notary
Public through one current identification document issued
by an official agency bearing the photograph and signature
of the individual like driver’s license, passport, etc.)
SUBSCRIBED AND SWORN to before'me in the City of Manila this 4th day of
November 20__ by JUAN DELA CRUZ, who has satisfactorily proven his identity to me
through his Non- Professional Driver’s License No. 1245 valid until December 5, 20__,
that he is the same person who personally signed the foregoing affidavit before me and
acknowledged that he executed the same.
MARIA CATHERINE G. SALURIO
Notary Public
Until December 31, 2022
PTR No. ; Calbayog, January , 2021
Roll of Attorneys’ No. 75345
IBP No.
MCLE Compliance No. New
Third Form: Affiant identified by one credible witness.
Requirements: (1) the witness is known personally by the
Notary Public; (2) the witness knows personally the affiant;
(3) the witness is not privy to the instrument, document or
transaction; and (4) oath or affirmation of the witness.
SUBSCRIBED AND SWORN to before me in City of Manila this 4th day of
November 200_ by JUAN DELA CRUZ, who has satisfactorily proven to me his identity
through MARIA B. SANTOS, who is personally known to me and who personally knows
the principal, that he is the same person who executed and personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
MARIA CATHERINE G. SALURIO
Notary Public
Until December 31, 2022
PTR No. ; Calbayog, January , 2021
Roll of Attorneys’ No. 75345
IBP No.
MCLE Compliance No. New
Fourth Form: Affiant is identified by two credible witnesses.
Requirements: (1) the witnesses each personally knows the
affiant; (2) both witnesses show to the Notary Public their
documentary identification; (3) both witnesses are not privy
to the instrument, document or transaction, and (5) Oath or
Affirmation of both witnesses.
SUBSCRIBED AND SWORN to before me in the City of Manila this 4th day of
November, 200_ by JUAN DELA CRUZ, who has satisfactorily proven their
identification to me, through:
EXPIRY DATE
Jose A. Santos with Driver’s License No. 1111 Nov. 10, 2005
Mario B. Reyes with.Driver’s License No. 2222 Feb. 8, 2006
who personally know the principal, to be the same person who executed and personally
signed the foregoing affidavit before me and acknowledged that he executed the same.
WE, JOSE A SANTOS and MARIO B. REYES, both of legal age,citizens, married,
residents of 32 Gelinos St., Sampaloc, Manila BHd 20 l nngit St., Sampaloc, Manila,
respectively, affirm under the penalty]f liw, Hint the following statements are true:
1. That Juan dela Cruz, the (principat/affiant/presentor/signor) (making the
acknowledgment/executing the affidavit/presently signing the instrument or
document is the same person named in the (instrument or document
Inscribed/affidavit/instrument or document presented);
2. That Juan dela Cruz is personally known to the undersigned witnesses;
3. That Juan dela Cruz does not possess a current identification document issued
by an official agency as "required in Sec. 12 (a), Rule II of the 2004 Rules on
Notarial Practice;
4. That it is the reasonable belief of the undersigned witnesses that due to Juan
dela Cruz’s circumstances {name the circumstances} it would be very difficult or
impossible for him to obtain the required official identification document;
5. That the undersigned witnesses are not privy to the (instrument, document or
transaction/affidavit/instrument or document presented and signed); and
6. That the undersigned witnesses have presented their respective valid
identification documents issued by an official agency, to wit:
Jose A. Santos with Driver’s License No._____Valid Until___
Mario B. Reyes with Driver's License No. Valid Until____
IN WITNESS WHEREOF, we have hereunto affixed our signatures this 4th day of
November 200__, in the City of Manila, Philippines.
(Sgd.) JOSE A. SANTOS (Sgd.) MARIO B. REYES
Witness Witness
I hereby certify that I have personally examined the abovenamed witnesses and they
avowed under the penalty of iaw to the whole truth of the contents of the
(oath/affirmation) they executed.
SUBSCRIBED AND SWORN to before me in City of Manila this 4th day of
November 200_ by JUAN DELA CRUZ, who has satisfactorily proven to me his identity
through MARIA B. SANTOS, who is personally known to me and who personally knows
the principal, that he is the same person who executed and personally signed the
foregoing affidavit before me and acknowledged that he executed the same.
