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C E R T I F I C A T I O N I, __________________________ hereby certify that the signature appearing on my new application form dated ____________, and the signature in my ________________ dated ___________ are also my customary signatures and for which reason I have signed both of my customary signatures below. DONE at ____________, Philippines on this _______ th day of _______, ______. 1. 1. 2. Signature over Printed Name 2. Signature over Printed Name 3. Signature over Printed Name 3. Signature over Printed Name Signature over Printed Name Signature over Printed Name

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C E R T I F I C A T I O N I, __________________________ hereby certify that the signature appearing on my new application form dated ____________, and the signature in my ________________ dated ___________ are also my customary signatures and for which reason I have signed both of my customary signatures below. DONE at ____________, Philippines on this _______ th day of _______, ______. 1.

1.

2.

Signature over Printed Name

2.

Signature over Printed Name

3.

Signature over Printed Name

3.

Signature over Printed Name

Signature over Printed Name

Signature over Printed Name