Republic of the Philippines
10th Judicial Region
REGIONAL TRIAL COURT
Office of the Executive Judge
Ozamiz City
In Re: Application for Level X Certification Application No. _____________________
Name,
Applicant,
x------------------------------------------------------------------------------------------------------------------x
APPLICATION
I, name of applicant, of legal age and a resident of address, state under oath that:
1. I am currently enrolled at the Misamis University College of Law at H.T. Feliciano
Street, Ozamiz City;
2. I have satisfactorily and successfully completed all my first year courses;
3. I will enroll in the school’s clinical legal education program for the semester of
academic year 2012-2013;
4. I am aware of and will abide by the limitations under Sections 4, and the duties and
obligations under Section 6 – 8 of Rule 138-A of the Rules of Court;
5. I have paid the necessary fees under Section 21(1) of Rule 141 of the Rules of Court
for the issuance of the Level X Certification. Attached herein is a copy of the official
receipt as proof of payment;
WHEREFORE, it is respectfully prayed that this application be approved and the Level X
Certification be issued
City of Ozamiz, __________________________
name of applicant
*** JURAT ***
SUBSCRIBED AND SWORN to before me, this _______day of _____________,
by ________(name)_________who exhibited to me his Valid ___________ ID with ID No.
____________________ issued at _________________ City, Philippines on _____________________.
Notary Public
Doc. No. _________;
Page No. _________;
Book No. ________;
Series of _________;