IN WITNESS WHEREOF, I have hereunto affixed my signature this
________________________ at Surigao City, Philippines.
RADCLIF CARLEX JOSE
(Affiant)
SIGNED IN THE PRESENCE OF
________________ ___________________
SUBSCRIBED AND SWORN to before me this ____ day of __________, Affiant exhibited to
me his proof of identification _________________________________ with validity period
issued by ________________________.
NOTARY PUBLIC
Doc No.
Page No.
Book No.
Series of 2021.