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PROVINCE OF MANILA)s.s
MUNICIPALITY OF QUEZON CITY)
I, MICHAEL DAIRO DAGDAG Filipino of legal age, married and with residence at Brgy Occidental Mindoro
after being duly sworn to in accordance with the law, hereby defense and state:
Kind : PISTOL
Make : ARMSCOR
Caliber : 45
Serial No.:
IN WITNESS WHEREOF, I have hereunto set my hand this ___th day of ___ 2o ____at
Sabalayan, Occidental Mindoro.
MICHAEL DAIRO DAGDAG
AFFIANT
SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public this ____th day of
_______20___ Affiant personally came and appeared with his Firearm License Card
_________ issued by the Philippines National Police an April 18, 2012 at Camp Crame,
Quezon City, bearing his photograph and signature, known to me as the same person who
personally signed the foregoing instrument before me and avowed under penalty of law to
the whole truth of the content of a said instrument.