VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING
I, AAAAA, Filipino, of legal age, and with postal address at Purok BBB, Brgy.
CCC, City of DDD, after having been duly sworn in accordance with law, depose
and state that:
1. I am the Petitioner in the above-entitled case;
2. I caused the preparation and filing of the foregoing Petition;
3. I have read the contents and allegations thereof and the facts stated
therein are true and correct based on my personal knowledge and/or on
the basis of copies of documents and records in my possession;
4. I have not commenced any other action or proceeding involving the same
issues in the Supreme Court, the Court of Appeals, or any other tribunal
or agency;
5. To the best of my knowledge and belief, no such action or proceeding is
pending in the Supreme Court, the Court of Appeals, or any other
tribunal or agency;
6. If I should thereafter learn that a similar action or proceeding has been
filed or is pending before the Supreme Court, the Court of Appeals, or
any other tribunal or agency, I undertake to report that fact within five
(5) days therefrom to this Honorable Court.
AAAA [signed]
Affiant
SUBSCRIBED AND SWORN to before me this __________________at
__________________ , affiant exhibiting to me her government-issued ID: ______________.
Doc. No. ______;
Page No. ______ ;
Book No. ______;
Series of 20