Republic of the Philippines )
City of ) S. S.
Province of )
I, __________________, being duly sworn, depose and say:
That I have been elected by the subscribers of the corporation as Treasurer thereof, to act as such until my successor has been duly elected and qualified in accordance with the by-laws of the corporation, and that as such Treasurer, I hereby certify under oath that at least 25% of the authorized capital stock of the corporation has been subscribed and at least 25% of the subscription has been paid, and received by me in cash for the benefit and credit of the corporation.
This is also to authorize the Securities and Exchange Commission and Bangko ng Pilipinas to examine and verify the deposit in the ____________________ in my name as treasurer in trust for __________________________________ in the amount of ______________________ (P _________________________) representing the paid-up capital of the corporation which is in the process of incorporation. This authority is valid and inspection of said deposit may be made even after the issuance of the Certificate of Incorporation. Should the deposit be transferred to another bank prior to or after incorporation, this will serve as authority to verify and examine the same. The representative of the Securities and Exchange Commission is also authorized to examine pertinent books and records of accounts of the corporation as well as supporting papers to determine the utilization and disbursement of our Certificate of Incorporation.
In case the said paid up capital is not deposited or withdrawn prior to the approval of the articles of incorporation, waive our right to a notice and hearing in the revocation of our Certificate of Incorporation.
SUBSCRIBED AND SWORN TO before me this _____ day of _________, at ________________, Philippines, affiant, exhibiting to me his/her Community Tax Certificate No. _______________________ issued on ________________, in ________________________, Philippines.
Series of _____.