Affidavit of Personal Service - Template, Sample Form Pro · PH-law

REPUBLIC OF THE PHILIPPINES  )
PROVINCE OF ________  )
CITY OR MUNICIPALITY OF ________  ) S.S.

AFFIDAVIT OF PERSONAL SERVICE

I, ________, Filipino, of legal age, single/married, with residence and postal address at ________, after having been duly sworn to in accordance with law, do hereby depose and state THAT:

§ 1. I am the sender/server of the document denominated as "________", dated ________ (the rue of which is hereto attached and made an integral part hereof as Annex "A";

§ 2. On ________, at approximately ________, I personally served and delivered an original/duplicate original copy of the said Document upon the recipient, ________ (the "Recipient");

§ 3. The Document was personally served upon and received by the Recipient at the latter's address located at ________;

§ 4. In acknowledgment of such personal service, the Recipient, through ________, affixed his/her/its signature upon the receiving copy of the Document, indicating thereon the date and time of receipt, a copy of which receiving copy is hereto attached as Annex "B";

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AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ________ day of ________, at ________, Philippines.

________
Affiant

ACKNOWLEDGMENT / JURAT

SUBSCRIBED AND SWORN TO before me this ________ day of ________, 20________, at ________, Philippines, affiant ________ personally appearing before me and exhibiting to me competent evidence of identity in the form of Postal ID No. ________, valid until ________, the affiant being known to me and to me known to be the same person who executed and voluntarily signed the foregoing Affidavit, and who acknowledged to me that the same is his/her free and voluntary act and deed.

WITNESS MY HAND AND NOTARIAL SEAL on the date and at the place above written.

________
NOTARY PUBLIC

Doc. No.: ________;
Page No.: ________;
Book No.: ________;
Series of ________.