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IN WITNESS WHEREOF, I have hereunto set my hand on this ____ day of _______________ in
___________.
_______________________ _______________________
VENDOR VENDEE
__________________________ __________________________
ACKNOWLEDGMENT
BEFORE ME, this ___ day of _________, 20__ in the Municipality of _____________, Province of
___________, Philippines, personally appeared ______________, with Driver's License No.
____________________________ expiring on ______________________, known to me to be the same
person who executed the foregoing instrument, and who acknowledged to me that the same is his free
act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal, on the day,
year, and place above written.
Name: ___________________________
Notary Public for :
Office Address of Notary Public _____
Appointment No. _____ Until
Roll of Attorneys No. _____
PTR No. ______;
IBP No. ______;