CERTIFICATION OF INDEPENDENT DIRECTOR
I, Name of Independent Director, Citizenship, of legal age and a resident of Address of Independent Director, after having been duly sworn to in accordance with law do hereby declare that:
1. I am an independent director of Name of Company.2. I am affiliated with the following companies or organizations:
3. I possess all the qualifications and none of the disqualifications to serve as an Independent Director of Name of Company, as provided for Section 38 of the Securities and Regulation Code and its Implementing Rules and Regulations.
Company/Organization Position Period of Service Name of Company 1 ---- ---- Name of Company 2 ---- ---- Other Companies ---- ----
4. I shall faithfully and deligently comply with my duties and responsibilities as independent director under the Securities Regulation Code.
5. I shall inform the corporate secretary of Name of Company of any changes in the abovementioned information within five days from its occurence.
Done, this date day of Month - Year at Name of Location/City.
Signature
Name of Affiant
Affiant
SUBCRIBED AND SWORN to before me this Date at Name of Location/City, affiant personally appeared before me and exhibited to me his Passport No. ___________________ issued at DFA, Manila on _____________.
Doc. No. _______:
Page No. _______:
Book No. _______:
Series of 2012.- https://www.affordablecebu.com/
