JURAT- Legal Forms
1.   JURAT
JURAT
SUBSCRIBED AND SWORN to before me, this 15th day of March, 2007 in the City of Quezon,
affiant exhibiting before me his Community Tax Certificate No. 123456, issued at Quezon City
on March 1, 2007.
ATTY. JANE ABLAZA
NOTARY PUBLIC for Quezon City
15 Carnation St., DRJVillage, Novaliches, Q.C.
Until Dec. 31, 2007
Roll No. 0001
P.T.R. No. 0002, 12/31/2007, Manila.
IBP No. 0003, 12/31/2007, Manila.
MCLE Compliance No. 1234
Serial No. of Commission: 07-11111
Doc. No. 5;
Page No. 6;
Book No. I;
Series of 2007
                              REPUBLIC OF THE PHILIPPINES)
                            CITY/MUNICIPALITY OF ______) SS.
                                     ACKNOWLEDGMENT
BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of _____________,
personally appeared _____________ 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 which (he/she) acknowledged to me as (his/her) free and voluntary act and
deed, consisting of only ______ (____) page/s, including this page in which this
Acknowledgement is written, duly signed by (him/her) and (his/her) 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 ______;
                                   COPY CERTIFICATION
I, ATTY. MAGDALENA R. LEPITEN, A NOTARY PUBLIC, IN THE CITY AND PROVINCE OF
CEBU, IS PRESENTED WITH AN INSTRUMENT OR DOCUMENT THAT IS NEITHER A
VITAL RECORD, A PUBLIC RECORD, NOR PUBLICLY RECORDABLE; THAT I CAUSED OR
SUPERVISED THE COPYING OF THE INSTRUMENT OR DOCUMENT; THAT I HAVE
COMPARED THE INSTRUMENT OR DOCUMENT WITH THE COPY; AND THAT I CERTIFY,
AFTER HAVING DETERMINED, THAT THIS COPY IS ACCURATE AND COMPLETE
COMPARED WITH THE ORIGINAL INSTRUMENT OR DOCUMENT COPIED.
DATE: ___________________________
Doc. No.                           ATTY. MAGDALENA R. LEPITEN
Page No.                           Notary Public for Cebu City and Cebu Province
Book No.                            Notarial Commission No. 280
Series of 2013                     Until December 31, 2013
                                    21-F Don Pedro Rodriguez St.,
                                    Capitol Site, Cebu City Philippines
                                    Roll No. 36617
                                    PTR No 137365, January 3, 2013, Cebu City
                                    IBP No. 567022 Lifetime
                                    Cebu City