LEGAL FORMS | Atty. Erik C.

Lazo

Legal Forms Reviewer

ACKNOWLEDGEMENT

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES
CITY OF __________________________

)
) S.S.

BEFORE
ME,
this
_______
day
of
___________________________, personally appeared:
Name

_________________

Competent Evidence of Identity

20______

in

Place of Issue

the

City

of

Date of Issue

_______________________________________
_______________________________________
______________________
______________________
_______________________________________
_______________________________________
______________________
______________________
known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date and
place above written.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC for ________________________

____________;
Commission
Serial
No.
____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________ / (Date of Issue) /
(Place of Issue)

JURAT

SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________ by ___________________________________________ with Passport No.
__________________________________, issued on ____________________________ at
___________________________________________.
Doc. No.____________;
Page No.
_________________

NOTARY PUBLIC
____________;

Commission

Serial

No.

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Book No.
_____________________
Series of 20__________.

Legal Forms Reviewer

____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________ / (Date of Issue) /
(Place of Issue)

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING OF PLEADING

VERIFICATION AND CERTIFICATION

REPUBLIC OF THE PHILIPPINES
CITY OF __________________________

)
) S.S.

I,
_____________________________________________,
Filipino,
of
legal
age,
residing
at
______________________________________________, after being sworn to in accordance with law, depose and
say THAT:
1. I am the Plaintiff in the above-entitled case;
2. The facts stated in the above complaint are true and correct to the best of my knowledge and
authentic records;
3. I have not commenced any action or filed any claim involving the same issues in any court,
tribunal or quasi-judicial agency and, to the best of my knowledge, no such other action or
claim is pending in them; and
4. If I should learn that the same or similar action or claim has been filed or is pending after its
filing, I shall report that fact within five (5) days from notice to the court or where the
complaint or initiatory pleading has been filed.
(Date and venue)

Name and Signature of Affiant

Jurat
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________ by ___________________________________________ with Passport No.
__________________________________, issued on ____________________________ at
___________________________________________.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC
____________;

Commission

____________;

Until

Serial

December

No.
31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________ / (Date of Issue) /
(Place of Issue)

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

CAPTIONS AND TITLES

IN THE SUPREME COURT

REPUBLIC OF THE PHILIPPINES

SUPREME COURT
Manila
JUAN DELA CRUZ
Petitioner,
S.C.
___________________
versus
Pleading)

G.R.

(Designation

No.
of

the

PEDRO DELOS SANTOS

Respondent.
x------------------------------x

IN THE COURT OF APPEALS

REPUBLIC OF THE PHILIPPINES

COURT OF APPEALS
Manila
JUAN DELA CRUZ
Petitioner,
C.A.
__________________
versus
Pleading)

G.R.

(Designation

No.
of

the

PEDRO DELOS SANTOS

Respondent.
x------------------------------x

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

IN THE REGIONAL TRIAL COURT

REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT
_______ Judicial Region
Branch _______
(Venue)
JUAN DELA CRUZ
Plaintif,
Civil
_________________
versus
Pleading)

Case

(Designation

No.
of

the

PEDRO DELOS SANTOS

Defendant.
x------------------------------x

IN SPECIAL PROCEEDINGS

(Caption)
In the Matter of
__________________________
__________________
__________________________
Pleading)
x------------------------------x

Sp.

Proc.

(Designation

No.
of

the

IN THE REGIONAL TRIAL COURT

(Caption)
THE PEOPLE OF THE
PHILIPPINES
Plaintif,
Criminal
____________
versus
Pleading)

Case

(Designation

of

No.
the

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

JUAN DELA CRUZ

Accused.
x------------------------------x

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

PETITION FOR APPOINTMENT AS NOTARY PUBLIC

IN THE MATTER OF THE APPLICATION FOR APPOINTMENT AS NOTARY PUBLIC

Case No. _________________________
ANNE LORRAINE CO y PONGOS,
Petitioner.
x------------------------------------------x
PETITION
Undersigned Petitioner and unto this Honorable Court most respectfully states that:
1. Petitioner is a Filipino citizen, over twenty-one years of age, and a resident in the Philippines
since
birth
and
with
office
address
at
______________________________________________________________________________________________
_______;
2. Petitioner was admitted to the Philippine Bar on ______________________ with Roll of Attorneys
No. __________________. A photocopy of Petitioners Certificate of Membership in the Philippine
Bar issued by the Office of the Bar Confidant is attached as Annex A of this petition;
3. Petitioner is a lawyer in good standing with clearances from the Office of the Bar Confidant of
the Supreme Court and the Integrated Bar of the Philippines, attached as Annexes B and
C;
4. Petitioner has not been convicted in the first instance of any crime involving moral turpitude,
nor charged in any administrative case in connection with her present profession;
5. Petitioner has not yet applied nor been commissioned as Notary Public in any other
jurisdiction;
6. Petitioner is a registered member of the Integrated Bar of the Philippines as supported by a
photocopy of the Official Receipt of yearly dues as of ________________________, attached as
Annex D;
7. Petitioner has paid his Professional Tax Receipt for the year ___________ under Official Receipt
No. _________________ dated ___________________ at ______________________. Photocopy of the
receipt is attached as Annex E of this petition;
8. Petitioner will submit all her notarial books and acknowledged documents after the expiration
of her notarial commission as provided for by law;
9. Petitioner possesses all the qualifications and none of the disqualifications for the office of
Notary Public and have read, understood and is willing to abide with the 2004 Rules on
Notarial Practice;
10. Petitioner is attaching as Annex F, a facsimile of her notarial seal prepared in accordance
with Section 2, Rule VII of the 2004 Rules on Notarial Practice for approval of this Honorable
Court, together with three (3) specimens of her official signature;
11. Also submitted are petitioners three (3) passport sized colored photographs with light
background, taken not more than 30 days prior to the filing of this petition;
WHEREFORE, it is more respectfully prayed that:

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

A certificate of authorization to purchase notarial seal as provided under Section 9, Rule III of the
2004 Rules of Notarial Practice, and certificate of authority for a Notarial Act as provided under Section 1,
Rule IX of the same Rules be issued in favor of the petitioner.
(Venue, date and signature)

VERIFICATION AND CERTIFICATION

REPUBLIC OF THE PHILIPPINES
CITY OF __________________________

)
) S.S.

I,
_____________________________________________,
Filipino,
of
legal
age,
residing
at
______________________________________________, after being sworn to in accordance with law, depose and
say THAT:
1. I am the Plaintiff in the above-entitled case;
2. The facts stated in the above complaint are true and correct to the best of my knowledge and
authentic records;
3. I have not commenced any action or filed any claim involving the same issues in any court,
tribunal or quasi-judicial agency and, to the best of my knowledge, no such other action or
claim is pending in them; and
4. If I should learn that the same or similar action or claim has been filed or is pending after its
filing, I shall report that fact within five (5) days from notice to the court or where the
complaint or initiatory pleading has been filed.
(Date and venue)

Name and Signature of Affiant

Jurat
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________ by ___________________________________________ with Passport No.
__________________________________, issued on ____________________________ at
___________________________________________.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC
____________;

Commission

____________;

Until

Serial

December

No.
31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

PTR No. _________________ / (Date of Issue) /

(Place of Issue)

10

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

DEMAND LETTER TO VACATE A CONDOMINIUM UNIT

(Date)

Mr. May Utang

(Address)

Dear Mr. Utang:

It has been 30 days since you received my letter dated ______________________ and still, you have failed to
pay and still refuses to pay your arrears which have now amounted to
_____________________________________ PESOS (___________________).
Please be reminded that I have sent you several letters of demand for you to pay your back rentals and
to vacate the premises but the same letters have been left unanswered. Consider this then, as my last
and final demand for you to pay your account within five (5) days from receipt and to VACATE the
premises within ten (10) days from receipt of this notice. Otherwise, I shall be constrained to commence
suit to protect my interests.

Very truly yours,

Miss Anne Lorraine Pongos Co

11

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

AFFIDAVIT OF LOSS DRIVERS LICENSE

REPUBLIC OF THE PHILIPPINES

)
CITY OF __________________________
) S.S.
x-------------------------------------------------x
AFFIDAVIT OF LOSS
I, Anne Lorraine Pongos Co, of legal age, Filipino, single and a resident of
______________________________________________ _________________________________________________, after
having been duly sworn to in accordance with law, depose and state THAT:
1. I am a duly-licensed driver in accordance with pertinent Land Transportation laws, rules and
regulations, and was issued a corresponding Non-Professional Driver's License with number
________________________________ which is valid until __________________________;
2. Sometime on __________________________________, said driver's license was misplaced and got
lost;
3. Efforts were exerted to locate said driver's license, but in spite of diligent search, it could not
be found and the same is now beyond recovery;
4. Said Driver's License has not been confiscated by the LTO, Police or other Traffic Enforcers for
any traffic violation;
5. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and to
support my application for the issuance of a new Non-Professional Driver's License, in lieu of
the one that was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

Anne

Lorraine

Pongos

Co
Philippine

Affiant
Passport

No.

______________
Issued

on

Issued

at

______________________________
_______________________________
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________
by
___________________________________________
with
Passport
No.
__________________________________,
issued
on
____________________________
at
___________________________________________.
Doc. No.____________;
Page No.
_________________

12

NOTARY PUBLIC
____________;

Commission

Serial

No.

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Book No.
_____________________
Series of 20__________.

Legal Forms Reviewer

____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

13

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

AFFIDAVIT OF LOSS PAWNSHOP TICKET

REPUBLIC OF THE PHILIPPINES

)
CITY OF __________________________
) S.S.
x-------------------------------------------------x
AFFIDAVIT OF LOSS
I, Anne Lorraine Pongos Co, of legal age, Filipino, single and a resident of
______________________________________________ _________________________________________________, after
having been duly sworn to in accordance with law, depose and state THAT:
1. Sometime
on
________________________,
I
pawned
my
_________________________________________________ with Tambunting Pawnshop located at
_________________________________________________________________________ and for which I was
issued Pawn Ticket/Receipt No. __________________________;
2. I kept the said pawn ticket in my wallet for safekeeping but unfortunately my wallet got lost;
3. Despite diligent search and efforts to locate the said wallet and pawn ticket, I could not find
the same such that I believe that they are now lost beyond recovery;
4. As such, I am executing this affidavit to attest to the foregoing facts and to enable me to
secure a duplicate or substitute copy of the ticket and/or redeem the above-described item
which I pawned.
IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

Anne

Lorraine

Pongos

Co
Philippine

Affiant
Passport

No.

______________
Issued

on

Issued

at

______________________________
_______________________________
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________
by
___________________________________________
with
Passport
No.
__________________________________,
issued
on
____________________________
at
___________________________________________.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

14

NOTARY PUBLIC
____________;

Commission

____________;

Until

Roll of Attorney

Serial

December

No.
31,

________________________
2

nd

Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

15

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

AFFIDAVIT OF LOSS PHILIPPINE PASSPORT

REPUBLIC OF THE PHILIPPINES

)
CITY OF __________________________
) S.S.
x-------------------------------------------------x
AFFIDAVIT OF LOSS
I, Anne Lorraine Pongos Co, of legal age, Filipino, single and a resident of
______________________________________________ _________________________________________________, after
having been duly sworn to in accordance with law, depose and state THAT:
1. On ______________________________________, I was issued a Philippine Passport by the
Department of Affairs in Manila;
2. Recently, I had tried to look for the said passport but the same could not be found;
3. Despite diligent search and efforts to locate the said passport, I could not find the same such
that I believe that it is now lost beyond recovery;
4. As such, I am executing this affidavit to attest to the foregoing facts and to support the
application for the issuance of a new one in lieu of the one which was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

Anne Lorraine Pongos Co

Affiant
Non-Professional
Driver's
License

No.

_________________
Valid

Until

________________________________________________
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________
by
___________________________________________
with
Passport
No.
__________________________________,
issued
on
____________________________
at
___________________________________________.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC
____________;

Commission

____________;

Until

Serial

December

No.
31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

16

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

AFFIDAVIT OF SERVICE

REPUBLIC OF THE PHILIPPINES

)
CITY OF __________________________
) S.S.
x-------------------------------------------------x
AFFIDAVIT OF SERVICE
I, Anne Lorraine Pongos Co, of legal age, Filipino, single and a resident of
______________________________________________ _________________________________________________, after
having been duly sworn to in accordance with law, depose and state THAT:
1. That
I
am
employed
as
a
messenger
of
Atty.
____________________________________________________
with
office
address
at
______________________________________________________________________________________________
_________________________________;
2. That on ______________________________, I served a copy of the following pleading/paper by
registered mail in accordance with Section 10 of Rule 13 of the Rules of Court:
Nature of Pleading/Paper
_____________________________
_____________________________
_____________________________
in Case No. ____________ entitled "_________________ v. _________________" by depositing a copy in the post
office in a sealed envelope, plainly addressed to the defendant's lawyer at his office with postage fully
paid, as evidenced by Registry Receipt No. ________ attached and with instructions to the post master to
return the mail to sender after ten (10) days if undelivered.
IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

Anne

Lorraine

Pongos

Co
Philippine

Affiant
Passport

No.

______________
Issued

on

Issued

at

______________________________
_______________________________
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________
by
___________________________________________
with
Passport
No.
__________________________________,
issued
on
____________________________
at
___________________________________________.
Doc. No.____________;

17

NOTARY PUBLIC
2nd Semester, School Year 2015 2016
Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Page No.
_________________
Book No.
_____________________
Series of 20__________.

Legal Forms Reviewer

____________;

Commission

____________;

Until

Serial

December

No.
31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

18

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

AFFIDAVIT OF DESISTANCE

Republic of the Philippines

Department of Justice
National Prosecution Service
OFFICE OF THE CITY PROSECUTOR
________________ City

AFFIDAVIT OF DESISTANCE
I, Anne Lorraine Pongos Co, of legal age, Filipino, single and a resident of
______________________________________________ _________________________________________________, after
having been duly sworn to in accordance with law, depose and state THAT:
1. I am the private complainant in a criminal case for Reckless Imprudence Resulting to Damage
to Property against ______________________________________________________ docketed as IS No.
_________________________________ before the Office of the City Prosecutor, (City/Municipality
and Province);
2. In this regard, the accused has already paid the damage to our vehicle;
3. In view of the payment by the accused and considering that I was not injured, I would like to
manifest that I now completely and absolutely exonerate the accused from any liability in
connection with the above-mentioned criminal case and that I am no longer interested, and I
hereby desist, in prosecuting the said criminal case;
4. As
such,
I
respectfully
pray
that
the
aforementioned
case
______________________________________________ be withdrawn and/or dismissed.

against

IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

Anne

Lorraine

Pongos

Co
Philippine

Affiant
Passport

No.

______________
Issued

on

Issued

at

______________________________
_______________________________
SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________
by
___________________________________________
with
Passport
No.
__________________________________,
issued
on
____________________________
at
___________________________________________.
Doc. No.____________;

19

NOTARY PUBLIC
2nd Semester, School Year 2015 2016
Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Page No.
_________________
Book No.
_____________________
Series of 20__________.

Legal Forms Reviewer

____________;

Commission

____________;

Until

Serial

December

No.
31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

20

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

JUDICIAL AFFIDAVIT DIRECT TESTIMONY OF AN ADOPTER IN AN ADOPTION CASE

Republic of the Philippines

REGIONAL TRIAL COURT
National Capital Judicial Region
Branch ________
___________ City
IN THE MATTER OF THE ADOPTION OF _____________________________
Case No. ______________________
ANNE LORRAINE CO y PONGOS,
Petitioner.
x------------------------------------------x
JUDICIAL AFFIDAVIT OF ANNE LORRAINE CO y PONGOS
I, ___________________, of legal age, married, and living at ___________________, petitioner in this
case, state under oath as follows:
PRELIMINARY STATEMENT
The person examining me is Atty. __________________________________________ with address at
_________________________________ ________________________________________________________________. The
examination is being held at the same address. I am answering his questions fully conscious that I do so
under oath and may face criminal liability for false testimony and perjury.

The judicial affidavit of petitioner Anne Lorraine Co y Pongos is executed to serve as her direct
testimony in the instant case. This judicial affidavit is offered to prove the following:
(1) Petitioner Anne Lorraine Co y Pongos has all the qualifications and all the requirements to
adopt ___________________________________________, a minor; and
(2) Minor ___________________________________________ may be adopted as provided by law.
It is respectfully prayed that the Honorable Tribunal admit this Judicial Affidavit of Anne Lorraine
Co y Pongos as the Direct Examination of the petitioner in order to expedite the proceedings.
QUESTIONS
were
propounded
by
petitioners
counsel,
Atty.
_______________________________________, in English, which the petitioner fully understands, while
ANSWERS were given/made by petitioner Anne Lorraine Co y Pongos in English/Tagalog and the
corresponding translation of her answer is provided after each question.

21

1) Question (Q)
Answer (A)

Please state your name and other personal circumstances for the record.
I am Anne Lorraine Co y Pongos, __________ years old, a resident of
_____________________________
___________________________________________,
single and a businesswoman. I am a Filipino citizen.

2) Q
A

What is your business?

I have a plastic factory in Valenzuela City and a dormitory in Sampaloc, Manila.

3) Q
A

Do you have any proof that you really own a factory and a dormitory?
Yes, maam! I have all the pertinent documents (Exhibit A).
2nd Semester, School Year 2015 2016
Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

4) Q
A

Are you the same Anne Lorraine Co y Pongo, the petitioner in this case?
Yes, maam!

5) Q
A

Have you been convicted of any crime?

No, maam!

6) Q
A

Do you have a child?

None!

7) Q
A

Have you undergone pre-adoption services?

Yes, maam!

8) Q
A

Do you have any proof that you really have undergone pre-adoption services?
Yes, maam (Exhibit B).

9) Q Do you think you are in a good position to provide for all the needs of the
child you want to adopt, to support, educate and care for the child to be
adopted?
Yes, maam!

10) Q
A

Why or how?
As a businesswoman, I earn more than three hundred seventy five thousand
pesos (375,000.00) a month. That is a net, not gross.

11) Q
A

Why do you want to adopt a child?

Because I am single and I cannot have a fetus in my womb since I am not in a
romantic relationship. Still, I want to become a mother, a real and genuine
mother. I want to love a child and be loved by my child.

22

Legal Forms Reviewer

12) Q Who is the child that you want to adopt? State her other personal
circumstances for the record.
Her name is __________________________________, _________ years old and she is
currently under the care of CHILDRENS SHELTER OF CEBU. Her biological
parents are both Filipinos and both residents of Cebu.

13) Q
A

When, how and when did you meet _________________________________________?

I met her last year, August 29 th, 2015, when I and my cousins had vacation in
Cebu from August 18th, 2015 to September 5th, 2015. One of my cousins asked
us to go with her in CHILDRENS SHELTER OF CEBU. My cousin was at the
fence
of
deciding
to
adopt
a
child.
There,
I
saw
_____________________________________________ and was introduced to her by one
of the staffs of CHILDRENS SHELTER OF CEBU.

14) Q
A

Why is she in CHILDRENS SHELTER OF CEBU? Where are her parents?

According to one of the staffs of CHILDRENS SHELTER OF CEBU who
introduced me to __________________________________ whose name I cannot
remember. _________________________________ was brought into CHILDRENS
SHELTER OF CEBU by her biological parents because her biological parents
could not afford to raise her and give or provide her needs as they only do
laundry for the others for their living and her father could not find a good and
stable job because of his serious illness which I do not know. Thus, they
decided to bring __________________________________________ into CHILDRENS
SHELTER OF CEBU.

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

15) Q
A

Have you met her biological parents?

Not yet!

16) Q
A

Do you have any idea if she is available for adoption?

Yes! She has been declared, judicially, available for adoption (Exhibit C).

17) Q
A

What is the age of _______________________________________ again?

________ years old.

18) Q
A

How did you know?

I asked the staff who introduced me to her and I also asked her. The said staff
also
showed
me
the
Certificate
of
Live
Birth
of
________________________________________________ (Exhibit D).

19) Q
A

Do you have documents necessary to adopt a child?

Yes, maam! I have (Exhibits C, C-1 to C-8).

IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

ANNE LORRAINE CO y PONGOS

Affiant

SUBSCRIBED and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________, Philippines. I hereby certify that I have personally examined the affiant and
that I am convinced that she understood and voluntarily executed the Judicial Affidavit.

Copy furnished:
THE CLERK OF COURT
(Address)

ATTESTATION
I,
Atty.
_______________________,
of
legal
age,
single
and
a
resident
of
__________________________________________________________, after having been duly sworn to in accordance
with law, hereby depose and state that:
1) I am the counsel of ANNE LORRAINE CO y PONGOS in Case No. _________________________;
2) I faithfully recorded or caused to be recorded the questions I asked and the corresponding
answers that the witness gave for her Judicial Affidavit; and
3) Neither I nor any other person then present or assisting her coached the affiant regarding the
latters answers.

IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of _________________ 20______
in the City of ___________________________, Philippines.

23

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

ATTY. ______________________________
Affiant

24

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

SUBSCRIBE and sworn to before me, this _______ day of _________________ 20______ in the City of
___________________________
by
Atty.
_____________________________________
with
Passport
No.
__________________________________,
issued
on
____________________________
at
___________________________________________.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC
____________;

Commission

____________;

Until

Serial

December

No.
31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

25

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

DEED OF ABSOLUTE SALE REGISTERED LAND

DEED OF SALE
KNOW ALL MEN BY THESE PRESENTS:
I, (Full name of vendor)
Filipino, single/married to ________________________________, of legal age, with residence and postoffice address at _________________________________________________________________________,
for and in consideration of the sum of __________________ PESOS (________), Philippine currency,
to me in hand paid by
(Full name of vendee)
Filipino,
of
legal
age
with
residence
_____________________________________________________________,

and

post-office

address

at

do hereby SELL, TRANSFER, and CONVEY, absolutely and unconditionally, unto the said
______________________________, his/her heirs and assigns, that certain parcel (or parcels) of land, together
with the buildings and improvements thereon, situated in (City and Province), and more particularly
described as follows:
(Description)
of which I am the registered owner in fee simple in accordance with the Land Registration Act, my title
thereto being evidenced by Transfer Certificate of Title No. ____________________________ issued by the
Register of Deeds of (City and Province).
It is hereby mutually agreed that the vendee shall bear all the expenses for the execution and
registration of this deed of sale.
IN WITNESS WHEREOF, I have hereunto signed this deed of sale _______ day of _________________
20______ in the City/Municipality of ___________________________, Philippines.

(Vendor)

SIGNED IN THE PRESENCE OF:

____________________________________
____________________________________
____________________________________

26

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES

CITY/MUNICIPALITY OF ________

)
) S.S.

BEFORE ME, this _______ day of _________________ 20______ in the City/Municipality of

___________________________, personally appeared:
Name

Competent Evidence of Identity

Place of Issue

Date of Issue

_______________________________________
_______________________________________
______________________
______________________
_______________________________________
_______________________________________
______________________
______________________
known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date and
place above written.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC for ________________________

____________;
Commission
Serial
No.
____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

27

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

DEED OF ABSOLUTE SALE UNREGISTERED LAND

DEED OF SALE
KNOW ALL MEN BY THESE PRESENTS:
(Full name of vendor), Filipino, single/married to ________________________________, of legal age,
with
residence
and
post-office
address
at
_________________________________________________________________________, for and in consideration of the
sum of __________________ PESOS (________), Philippine currency, to him/her in hand paid by
(Full name of vendee), Filipino, of legal age, with residence and post-office address at
_________________________________,
do hereby SELL, TRANSFER, and CONVEY, absolutely and unconditionally, unto the said
______________________________, DOES HEREBY SELL, TRANSFER, AND CONVEY unto said
(Full name of vendee), his/her heirs and assigns, that certain parcel (or parcels) of land, together
with all the buildings and improvements thereon belonging to the vendor and in present possession of
_____________________________________,
situated
in
______________________________________________________________________, and more particularly described
as follows, to wit:
(Description: State nature of each piece of land and its improvements, situation,
boundaries, area in square meters, whether or not the boundaries are visible on the land
by means of monuments or otherwise, and in the affirmative case, in what they consist;
the permanent improvements, if any, existing on the property for current year or years
when registration is made; the assessed value of the property for the year.)
That it is hereby declared that the boundaries of the foregoing land are visible by means of
___________________________; that the permanent improvements existing thereon consist of
_____________________________________________________________ (If none, state so); that the land is assessed
for the current year at _________________________ as per Tax Declaration No. ___________________, and the
buildings and/or improvements, at _________________________ as per Tax Declaration No.
___________________, of the City/Provincial Assessor of _____________________________________________;
The above-described real estate, not having been registered under Act No. 496 nor under the
Spanish Mortgage Law, the parties hereto have agreed to register this instrument under the provisions of
Section 194 of the Revised Administrative Code, as amended by Act No. 3344.
IN WITNESS WHEREOF, the parties hereto have signed this deed of transfer this _______ day of
_________________ 20______ in the City/Municipality of ___________________________, Philippines.

(Vendor)

(Vendee)

SIGNED IN THE PRESENCE OF:

28

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

____________________________________
____________________________________
____________________________________

29

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES

CITY/MUNICIPALITY OF ________

)
) S.S.

BEFORE ME, this _______ day of _________________ 20______ in the City/Municipality of

___________________________, personally appeared:
Name

Competent Evidence of Identity

Place of Issue

Date of Issue

_______________________________________
_______________________________________
______________________
______________________
_______________________________________
_______________________________________
______________________
______________________
known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date and
place above written.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC for ________________________

____________;
Commission
Serial
No.
____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

30

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

DEED OF ABSOLUTE SALE PORTION OF A PIECE OF LAND (PORTION OF REAL ESTATE)

DEED OF SALE
KNOW ALL MEN BY THESE PRESENTS:

I, (Full name of vendor), Filipino, single/married to ________________________________, of legal age,

with
residence
and
post-office
address
at
_________________________________________________________________________,
for and in consideration of the sum of __________________ PESOS (________), Philippine currency,
to me in hand paid by
(Full name of vendee), Filipino, of legal age with residence and post-office address at
__________________________________,
do hereby SELL, TRANSFER, and CONVEY unto the said ______________________________, his/her
heirs and assigns, the certain parcel (or parcels) of land, together with the buildings and improvements
thereon, situated in (City and Province), and more particularly described as follows:
(Copy here the description of the portion sold as subdivided as per plan and technical
description of such portion approved and certified by the Bureau of Lands)
which said parcel of land is a portion of Lot No. ___________, Block No. _________ of the Cadastral Survey of
the ____________________, as described in the Transfer Certificate of Title No. ____________________ of the
Registry
of
Deeds
of
________________________________,
issued
in
favor
of
____________________________________;
That the remaining portion
segregated, is described as follows:

of parcel of land from which the above-described portion was

(Copy here the description of the remaining portion as per plan and technical description
approved and certified by the Bureau of Lands)
IN WITNESS WHEREOF, I have hereunto signed this deed on this _______ day of _________________
20______ in the City/Municipality of ___________________________, Philippines.

(Vendor)

SIGNED IN THE PRESENCE OF:

____________________________________
____________________________________
____________________________________

31

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

32

Legal Forms Reviewer

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES

CITY/MUNICIPALITY OF ________

)
) S.S.

BEFORE ME, this _______ day of _________________ 20______ in the City/Municipality of

___________________________, personally appeared:
Name

Competent Evidence of Identity

Place of Issue

Date of Issue

_______________________________________
_______________________________________
______________________
______________________
_______________________________________
_______________________________________
______________________
______________________
known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date and
place above written.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC for ________________________

____________;
Commission
Serial
No.
____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

33

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

CONTRACT TO SELL OF A CONDOMINIUM UNIT (SHORT VERSION)

DEED OF ABSOLUTE SALE

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Absolute Sale made and executed in the City/Municipality

___________________________, this _______ day of _________________ 20______, by and between:

of

_______________________________________,
of
legal
age,
single/married
to
_______________________________________,
Filipino/Filipinos
(if
married),
and
residing
at
______________________________________________________________________________,
hereinafter
referred to as the Vendor/Vendors;
(or _______________________________________, a domestic corporation duly organized and
existing
under
the
laws
of
the
Philippines,
with
postal
address
at
______________________________________________________________________________
herein
duly
represented by _______________________________________, President , hereinafter referred to as the
Vendor;)
and
_______________________________________,
of
legal
age,
single/married
to
_______________________________________,
Filipino,
and
residing
at
______________________________________________________________________________,
hereinafter
referred to as the Vendee;
(or _______________________________________, a domestic corporation duly organized and
existing
under
the
laws
of
the
Philippines,
with
postal
address
at
______________________________________________________________________________
herein
duly
represented by _______________________________________, President , hereinafter referred to as the
Vendee;)

WITNESSETH
WHEREAS, the vendor/vendors is/are the true and lawful owner/owners of a condominium unit
including
any
and
all
improvements
existing
thereon,
situated
at
________________________________________, covered by Condominium Transfer Certificate of Title No.
____________________ of the Registry of Deeds of ______________________________________, and which
property is specifically described as follows:
(Description of the property)
WHEREAS, the Vendee has offered to buy the subject property from the Vendor/Vendors for and in
consideration of the sum of ________________________________________________ PESOS (__________________),
Philippine currency, and the Vendor/Vendors has/have accepted the offer;
WHEREAS, the VENDOR/VENDORS agrees/agree to shoulder and pay the corresponding capital
gain tax. Transfer of title to property from the VENDOR/VENDORS to the VENDEE shall be shouldered by
the latter. Notarial fee and costs of preparation of this deed of absolute sale shall be shouldered by the

34

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

VENDOR/VENDORS. The VENDEE, on the other hand, agrees to pay all real estate taxes from the time of
this deed of absolute sale is executed.
NOW
THEREFORE,
for
and
in
consideration
of
the
said
amount
of
________________________________________________ PESOS (__________________), receipt of which in full is
hereby acknowledged by the vendor/vendors to his/her/their/its full and complete satisfaction, the
VENDOR/VENDORS hereby SELLS, TRANSERS AND CONVEYS (or SELL, TRANSER AND CONVEY) in a
manner absolute and irrevocable unto the VENDEE, his/her/its heirs, successors and assigns, all
his/her/its rights, title and interest in the above-described property, free from any and all liens and
encumbrances.
IN WITNESS WHEREOF, the parties hereto have signed this deed of transfer this _______ day of
_________________ 20______ in the City/Municipality of ___________________________, Philippines.

(Vendor)

(Vendee)

By:
_____________________________
President
(in case of corporation)

SIGNED IN THE PRESENCE OF:

____________________________________
____________________________________
____________________________________

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES
CITY/MUNICIPALITY OF ________

)
) S.S.

BEFORE ME, this _______ day of _________________ 20______ in the City/Municipality of

___________________________, personally appeared:
Name

Competent Evidence of Identity

Place of Issue

Date of Issue

_______________________________________
_______________________________________
______________________
______________________
_______________________________________
_______________________________________
______________________
______________________

35

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date and
place above written.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC for ________________________

____________;
Commission
Serial
No.
____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)
PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

36

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

EASEMENT OF RIGHT OF WAY

EASEMENT OF RIGHT OF WAY

KNOW ALL MEN BY THESE PRESENTS:
This AGREEMENT OF EASEMENT OF RIGHT OF WAY, entered into this _______ day of
_________________ 20______, by and between A, owner of the dominant estate, of age, single (or married
to ___________________________________), and resident of __________________________________, and B, owner
of the servient estate, of age, single and resident of __________________________________,
WITNESSETH
That A is the owner of a parcel of agricultural land located in __________________________________,
Philippines, and more particularly described as follows:
(Description of As property)
which property is covered by Transfer Certificate of Title No. ____________________ of the Registry of Deeds
of the province of ______________________________________, which lot is adjacent to Bs property, and
more particularly described as follows:
(Description of Bs property)
which property is covered by Transfer Certificate of Title No. ____________________ of the Registry of Deeds
of the province of ______________________________________;
That A, in order to have access to and from, and to cultivate his/her above-mentioned land, and
so as to have an outlet to __________________________________, which is the nearest public road and least
burdensome to the servient estate and to third persons, it would be necessary for him/her to pass
through Bs property, and for this purpose, a path or passageway of not less than two (2) meters wide
through the whole length of the western side of Bs property is necessary for the use of A and for all
his/her needs in cultivating his/her estate;
That said path or passageway is particularly described in the attached plan, Annex A.
WHEREFORE, for and in consideration of the sum of ________________________________ PESOS
(________________), receipt whereof is hereby acknowledged by B, the latter agrees and permits A to
have a permanent easement of right of way over the abovementioned property of said B limited to not
more than two (2) meters wide throughout the whole length of the western side of said property and as
specifically indicated in the attached plan which is made an integral part of this contract, as Annex A.
It is further agreed that B shall deliver unto A all the necessary papers, deeds, and titles in
relation to the servient estate in order to facilitate the registration of the above-mentioned right of way,
in accordance with law.
This agreement shall be binding between the parties and upon all their heirs, successors, and
assigns.

37

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

IN WITNESS WHEREOF, the parties hereto have signed this agreement the day and year first
above written, in the City/Municipality of ___________________________, Philippines.

____________________________________________
__________________________________________
(Signature of owner of dominant estate)
(Signature of owner of
servient estate)

SIGNED IN THE PRESENCE OF:

____________________________________
____________________________________
____________________________________

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES
CITY/MUNICIPALITY OF ________

)
) S.S.

BEFORE ME, this _______ day of _________________ 20______ in the City/Municipality of

___________________________, personally appeared:
Name

Competent Evidence of Identity

Place of Issue

Date of Issue

_______________________________________
_______________________________________
______________________
______________________
_______________________________________
_______________________________________
______________________
______________________
known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date and
place above written.
Doc. No.____________;
Page No.
_________________
Book No.
_____________________
Series of 20__________.

NOTARY PUBLIC for ________________________

____________;
Commission
Serial
No.
____________;

Until

December

31,

Roll of Attorney
________________________
IBP No. _________________ / (Date of Issue) / (Place

of Issue)

38

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |

LEGAL FORMS | Atty. Erik C. Lazo

Legal Forms Reviewer

PTR No. _________________

/ (Date of Issue) /

(Place of Issue)

39

2nd Semester, School Year 2015 2016

Co, Anne Lorraine Pongos |