For the City / Province Notarial registry No.: Valid Until IBP NO. PTR NO. ROLL
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Entry No./ Doc No.
Date of the Notarial Act
Type of Notarial Act
Title and Description of Document
Name and Address of Principal/Parties
Competent Eidence of !dentity
Name and Address of "itnesses
#ee/ Charge
Address Remar&s/ Other/ $here Notari%ation Circumstance $as s performed if outside
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( * )
+
,
E0ecuted ! here1y certify that during the past $ee& instruments $ere 2$orn To Ac&no$ledge
1efore me. ATT3. NOTAR3 P456!C
Entry No./ Doc No.
Date of the Notarial Act
Type of Notarial Act
Title and Description of Document
Name and Address of Principal/Parties
Competent Eidence of !dentity
Name and Address of "itnesses
#ee/ Charge
Address Remar&s/ Other/ $here Notari%ation Circumstance $as s performed if outside
7
8
9
:
';
E0ecuted ! here1y certify that during the past $ee& instruments $ere 2$orn To Ac&no$ledge
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