REPUBLIC OF THE PHILIPPINES
First Judicial Region
REGIONAL TRIAL COURT
Office of the Executive Judge
Dagupan City
In Re: Application for Level 1 Certification, Application No. __________
HENRY SMITH COQUIA ABALOS,
Applicant.
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APPLICATION
I, HENRY SMITH COQUIA ABALOS, of legal age and resident of 289
Tebeng District Dagupan City, Pangasinan, Region 1, state under oath that:
1. I am currently enrolled at the University of Pangasinan, College of Law at
Arellano Street, Downtown District, Dagupan City, Pangasinan
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 second
semester term of academic year 2020-2021;
4. I am aware of and will abide by the limitations under Section 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 1 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 1 Certification be issued.
City of Dagupan, 24th day of February, 2021.
HENRY SMITH C. ABALOS
Applicant
SUBSCRIBED AND SWORN to before me this 24th day of February2021 by the
Affiant who is personally known to me or whom I have identified through competent
evidence of identity and who exhibited his Driver’s License with ID No. __________
issued at Dagupan City.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2021