Form 104

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PRC Form

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is/has been employed with the above-named office/company located at

20 aton

Issued on

Doc. No.Page No.Book No.Series of

R. JIGGER FRANCIA BUGTONG

2. This form is good only one office/company.3. Certificate of employment must accompany this Certificate of Experience.

Notary PublicIMPORTANT :1. The Certifying officer should be a registered professional of the same discipline whose date of registraion is prior to the date

Certificate of Registration No.

Affiant exhibited to

of employment and PRC ID must be valid.

Affiant (Certifying Officer) (Signature above printed name)

me this Community Tax Certificate No. issued at

POSITION HELD

CERTIFICATE OF EXPERIENCE TO THE BOARD OF: ELECTRICAL ENGINEERING

for the period and performed duties indicated below:SPECIFIC WORK/FUNCTIONS

ADDRESS/E-MAIL/TELEPHONE NO./FAXNO.

day ofSUBSCRIBED AND SWORN to before me this

NAME OF COMPANY / OFFICE

PRC Form No. 104 (revised March 2003)

This is to CERTIFY that MFROM TO

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