Republic of the Philippines

City of Manila

)
) S.S

AFFIDAVIT OF SERVICE
I, ________________, of legal age, married, and a resident of
______________, after having been duly sworn in accordance with law, hereby
respectfully states:
1.

That I am the Secretary / Legal Aide of ____________ with office

address at _________________ Philippines;

2.

That in my aforementioned capacity, I served copies of the

Petition for Review, in the case entitled ___________ pending
before the Court of Appeals, on the following parties at their
respective addresses and on the dates indicated below:

Name

Address

Date of Service
09 November 2015
09 November 2015
09 November 2015
09 November 2015

Mode of Service
Registered Mail
Registered Mail
Registered Mail
Registered Mail

By depositing a copy in the post office, in a sealed envelope, plainly

addressed to the party or his attorney at his office/ residence with postage fully
prepaid, as evidenced by Registry Receipt No. ___________________ hereto
attached, and with instructions to the postmaster to return the mail to the sender
after ten (10) days, if undelivered.
IN WITNESS WHEREOF, I have hereunto set my hand this 9 th day of
November 2015 in the City of Manila.

___________________

SUBSCRIBED AND SWORN to before me this ______ day of

________________ in the City of Manila, affiant exhibiting to me
_____________________ issued at the City of Manila, Philippines.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2015.