AFFIDAVIT OF SERVICE

I/We, the undersigned, of legal age, Filipino/s, with office address at 32 Profugo corner
Bonifacio St., Brgy. 5, Lucena Citye, after having been sworn to in accordance with law, depose and
state, that:

1. On dates herein stated, Notices/Demands were served to check’s drawer/issuer ANNA D.

MORTILLA with address at DONA CONCHA SUBD MAMALA II SARIAYA QUEZON to wit:

Notices/ Mode of
Date of Service Outcome of Service
Demands Service
10/8/19 Final Notice of Dishonor Personal Received By Employee of Subject-
with Demand of Full Rosa Delfina, Co-Maker- Mr. Alfredo
Payment Tabarina and Husband of Co-maker-
Ms. Mortilla, Weira Blanca
10/10/19 Final Notice of Dishonor Personal Received By, Co-Maker- Mr. Alfredo
with Demand of Full Tabarina and Nephew of Co-maker Ms.
Payment Mortilla, Weira Blanca.

With Notation of Co-Maker Tabarina

that a copy of Notice of Dishonor was
forwarded to Ms. Mortilla.
10/11/19 Final Notice of Dishonor Personal Received By, Co-Maker- Mr. Alfredo
with Demand of Full Tabarina and Niece of Co-maker Ms.
Payment Mortilla, Weira Blanca, according to
her niece, Ms. Anna Mortilla is not
feeling well that time.
10/12/19 Final Notice of Dishonor Personal Received By, Co-Maker- Mr. Alfredo
with Demand of Full Tabarina, according to her co-maker,a
Payment copy of the notice of dishonor was
forwarded to Ms. Mortilla last October
12, 2019.
10/14/19 Final Notice of Dishonor Registered Registry Receipt No. 114 059 879 ZZ;
with Demand of Full Mail Quezon Capitol Post Office
Payment

2. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I/we have hereunto set my/our hand/s this 14th day of
October, 2019 in the Lucena City, Quezon Province.

JERICO J. AFABLE ROUEL A. ODIVER

Affiant Affiant
LICENSE ID No. D09-08-002649 LICENSE IDNo. D09-00-081249

SUBSCRIBED AND SWORN to before me this 14th day of October, 2019 in the
Lucena City, Quezon Province, with the affiant/s exhibiting to me his/her SSS/LICENSE
ID Cards as his/her competent evidence of identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
1. Series of ______.