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(Republic of the Philippines) _________________________________S.S.

I, _Jeffrey Tible Hipolito___________________________, of legal age and a resident of _#57 Zone 2


Camaligan Camarines Sur , after having been duly sworn in accordance with law hereby depose and
state:

1. I have entered into a Service Agreement with Acadsoc Limited (“company”) to be a Service
Provider and have read and clearly understand all the terms and conditions of the same.
2. That through one of the provisions in the Service Agreement, I have confirmed and agreed to be
solely responsible for providing accurate details of my preferred remittance system for duly
authorized collection and/or receipt of my service fees.
3. That due to time and distance constraints, particularly the difficulty of going to Shenzhen to
engage my preferred remittance company, I hereby authorize any employee, staff or any duly
authorized personnel of the company to personally receive and remit directly my service fees to
any of the company’s duly accredited medium of remittance.
4. That I further authorize any employee, staff or any duly authorized personnel of the company to
submit any and all documents that may be required by the aforesaid remittance agency in
connection with the foregoing purpose, and to pay all corresponding fees and charges, if any, via
deduction and/or withholding of a portion of my service fees.
5. That by doing so, I am holding the company harmless and free from any and all claims, demands,
suits, causes of action, damage, costs, expenses, attorney’s fees, and obligations of any nature
whatsoever arising from or in connection with the provisions of this affidavit unless there is
inexplicable gross negligence or willful and malicious intent on the part of the company.
6. That I am executing this Affidavit to attest to the truth of the foregoing and for all legal intents
and purposes the same may be used.
AFFIANT FURTHER SAYETH NAUGHT.

In witness hereof, I have hereunto affixed my signature this ______15th____ day of


________uSeptember___________,
in the Municipality of ____Camaligan_______________________________________________________.

_______________Jeffrey Tible Hipolito___________________________


Affiant

SUBSCRIBED AND SWORN to before me on __September 15_________ 2018 in


____________________, affiant exhibiting to me _________________________________ issued on
______________________________________ and valid competent evidence of identity to be the same
person who presented the instrument and signed such instrument in my presence and who took an oath
before me as such to said instrument.

Doc. No: ______;


Page No: ______;
Book No: ______;
Series of 2018

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