CERTIFICATE OF INDEBTEDNESS
KNOW ALL MEN BY THESE PRESENTS:
I, DR. MICHAELLA V. DE LARA of legal age, Filipino, and a resident of Nr.
29, Unit-B, 11th Avenue corner Liberty Avenue, Barangay Socorro, Cubao,
Quezon City, where I also holding a Dental Clinic under a business trade name:
MILES FOR SMILES DENTAL HEALTH CARE CLINIC, after being duly sworn to in
accordance with law, witnesseth and declare:
That I hereby certify that BGEN ANGELICA DE LARA TORRES O-11363
DS has an outstanding debt, as of this date, in the sum of THREE MILLION
PESOS (P3,000,000.00), Philippine Currency.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of
June 2021, in Quezon City, Philippines.
DR. MICHAELLA V. DE LARA
Affiant/Creditor
ID No.____________________________
Issued on/Valid until:________________
Issued by _________________________
Conformed:
BGEN ANGELICA DE LARA TORRES
Debtor
ID No.____________________________
Issued on/Valid until:________________
Issued by _________________________
SUBSCRIBED AND SWORN to before me this 3rd day of June 2021, in
Quezon City, affiant exhibited to me his/her government issued identification
document as indicated above as proof of his/her identity.
Doc. No. ____
Page No. ____
Book No. ____
Series of 2021.
CERTIFICATE OF INDEBTEDNESS
KNOW ALL MEN BY THESE PRESENTS:
I, DR. FERDINAND M. ORATA of legal age, Filipino, and a resident of Nr.
29, Unit-B, 11th Avenue corner Liberty Avenue, Barangay Socorro, Cubao,
Quezon City, where I also holding a Dental Clinic under a business trade name:
MILES FOR SMILES DENTAL HEALTH CARE CLINIC, after being duly sworn to in
accordance with law, witnesseth and declare:
That I hereby certify that BGEN ANGELICA DE LARA TORRES O-11363
DS has an outstanding debt, as of this date, in the sum of TWO MILLION
PESOS (P2,000,000.00), Philippine Currency.
IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of
June 2021, in Quezon City, Philippines.
DR. FERDINAND M. ORATA
Affiant/Creditor
ID No.____________________________
Issued on/Valid until:________________
Issued by _________________________
Conformed:
BGEN ANGELICA DE LARA TORRES
Debtor
ID No.____________________________
Issued on/Valid until:________________
Issued by _________________________
SUBSCRIBED AND SWORN to before me this 3rd day of June 2021, in
Quezon City, affiant exhibited to me his/her government issued identification
document as indicated above as proof of his/her identity.
Doc. No. ____
Page No. ____
Book No. ____
Series of 2021.
CERTIFICATE OF FULL PAYMENT
Know all men by theses presents:
THIS IS TO CERTIFY that BGEN ANGELICA DE LARA TORRES O-11363 DS
of legal age, and a resident of #17 Gallego St., Camp Aguinaldo, Quezon City,
has fully paid her loan obligation the amount of TWO MILLION PESOS
(PHP.2,000,000.00), Philippine Currency, to DR. FERDINAND M. ORATA,
the undersigned, likewise of legal age, Filipino, and with residence address at
Nr. 29, Unit-B, 11th Avenue corner Liberty Avenue, Barangay Socorro, Cubao,
Quezon City.
This certification is being issued for whatever purposes this may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this _____day
of _______20_____, in ______________, Philippines.
BGEN ANGELICA DE LARA TORRES DR. FERDINAND M. ORATA
Debtor Creditor
ID No.______________________ ID No.______________________
Issued on/Valid until___________ Issued on/Valid until___________
Issued by___________________ Issued by___________________
SIGNED IN TE PRESENCE OF
_________________________ ___________________________
ACKNOWLEDGEMENT
Republic of the Philippines )
Quezon City ) S.S.
BEFORE ME, a notary public for and in Quezon City, personally appeared the parties above
with their respective IDs as indicated above.
known to me to be the same persons who executed the certification of full payment and they
acknowledged to me that the same is their free and voluntary act and deed.
WITNESS my hand and seal on the date and in the place above-written.
Doc. No. _________
Page No. _________
Book No. ________
Series of 2021.
CERTIFICATE OF FULL PAYMENT
Know all men by theses presents:
THIS IS TO CERTIFY that BGEN ANGELICA DE LARA TORRES O-11363 DS
of legal age, and a resident of #17 Gallego St., Camp Aguinaldo, Quezon City,
has fully paid her loan obligation the amount of THREE MILLION PESOS
(PHP.3,000,000.00), Philippine Currency, to DR. MICHAELLA V. DE LARA,
the undersigned, likewise of legal age, Filipino, and with residence address at
Nr. 29, Unit-B, 11th Avenue corner Liberty Avenue, Barangay Socorro, Cubao,
Quezon City.
This certification is being issued for whatever purposes this may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this _____day
of _______20_____, in ______________, Philippines.
BGEN ANGELICA DE LARA TORRES DR. MICHAELLA V. DE LARA
Debtor Creditor
ID No.______________________ ID No.______________________
Issued on/Valid until___________ Issued on/Valid until___________
Issued by___________________ Issued by___________________
SIGNED IN TE PRESENCE OF
_________________________ ___________________________
ACKNOWLEDGEMENT
Republic of the Philippines )
Quezon City ) S.S.
BEFORE ME, a notary public for and in Quezon City, personally appeared the parties above
with their respective IDs as indicated above.
known to me to be the same persons who executed the certification of full payment and they
acknowledged to me that the same is their free and voluntary act and deed.
WITNESS my hand and seal on the date and in the place above-written.
Doc. No. _________
Page No. _________
Book No. ________
Series of 2021.
