Form No.

1 Signature of Counsel

As required by Bar Matter No. 1132, April 1, 2003 To show compliance with Sec 10 of Rule 139-A that default in the payment of the annual dues for six months shall warrant the suspension of members of the Integrated Bar, and default in such payment for one year shall be a ground for removal of the name of the delinquent member from the Roll of Attorneys

For Lawyers who pay lifetime membership fees,

Lifetime Membership No. is indicated instead of the IBP No. (Professional Tax Receipt) in compliance with Sec. 139 of the Local Tax Code To assure that the person signing is a lawyer

ATTY. ABE O. GADO Counsel for ________ Unit 1, X building, Recto, Manila IBP No. 123456; 01/10/10 Manila PTR No. 1234567; 01/10/10 Manila Roll No. 12345; 5/05/05 MCLE No. 9/09/09 MCLE No. 9/09/09 I II 001234; 005678;

As required by Bar Matter effective January 1, 2009

No.

1922,

as

amended,

For those who are exempted, the number of their Certificate of Exemption must be indicated