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REPUBLIC OF THE PHILIPPINES)

) S. S.

AFFIDAVIT
I, ____________________, of legal age, Filipino citizen, with residence at
Brgy Poblacion, Makati City, after being duly sworn in accordance with the law,
hereby depose and state;

1. That I am a son of Mr. _________________;

2. That my father signed the Customer Account Information with his


fingerprint;

3. That I have witnessed my father voluntarily and freely signed the said
document with his fingerprint;

4. That I have executed this affidavit in compliance to the request of Belson


Securities, Inc.; and

5. That I hereby attest to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hand this___________________,


_______________________.

Affiant

SUBSCRIBED AND SWORN TO before me this ___________________, in


________________________, affiant exhibited to me her competent evidence of
identity with details ___________________________________, which will expire on
____________________, issued in the Philippines.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2021.

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