REPUBLIC OF THE PHILIPPINES )

PASAY CITY ) S.S.

AFFIDAVIT OF SERVICE

I, _____________________, as representative of _____________________, with address at

_______________________________, after having been duly sworn to in accordance with law, hereby depose and
state that:

On __ July 2019, I served the following pleading/paper:

Title of Pleading :

Case Title & No. :

Court :

pursuant to Section 3, 4, 5, 6, 7 & 10, Rule 13 of the Rules of Court, as follows:

By Registered Mail and private courier to:

[X] By depositing a copy on __ day of July 2019, in Post

Office at ___________________ as evidence by
Registry Receipt(s) No(s). ___________________,
_____________________, _____________________,
_____________________, _____________________
and hereto attached and indicated after the name(s) of
the addressee(s), with postage fully prepaid and with
instructions to return to sender after ten (10) days if
undelivered

The foregoing mode of service/filing by registered mail was resorted to, personal service/filing not being
practical because of:

a. the distance of the Court/adverse party/counsel’s address;

b. time constraints;
c. worsening traffic situation in Metro Manila and other circumstances which are beyond control;
d. lack of office manpower;
e. fortuitous event; and
f. ___________________________________

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of July 2019 in _______________, affiant
exhibiting to me his __________________________ and ____________________ as his competent evidence of
identity.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series 2019.