NOTARIAL REGISTER OF ATTY. GENEVIEVE S.
TERSOL
Under appointment made on the ____________ of _____________________________________,
NAMES &
ENTRY TITLE/DESCRIPTION NAMES & ADDRESSES
ADDRESSES OF
NUMBER OF INSTRUMENT OF PARTIES
WITNESSES
Page ____
Judicial Form No. 143, as amended
of _____________________________________, Philippines, for the year
and expiring December 31
OTHER PLACE OF
COMPETENT NOTARIZATION
DATE & TIME
EVIDENCE TYPE OF FEES & OTHER THAN
OF
OF NOTARIAL ACT O.R. NO. OFFICE OF
NOTARIZATION
IDENTITY NOTARY PUBLIC
AND/OR REMARKS
executed
I HEREBY CERTIFY that during the past week instruments were sworn to
before me.
Acknowledged
Date _____________________________________ ATTY. JAYDEE
PEREGRINO-CO
Notary Public