REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

NATIONAL CAPITAL JUDICIAL REGION
MAKATI CITY
BRANCH ____

ABC
Plaintiff,

Civil Case No. ____

For: DAMAGES

vs.
DEF
Defendant
x------------------------------x

COMPLAINT
[Plaintiff], through counsel, respectfully states that:
1.
2.
3.
[Body]

PRAYER
WHEREFORE, Premises considered plaintiff respectfully prays for the ff.:
1.
2.
3.
The plaintiff also prays for such other relief as may just and equitable under the
circumstances .
[Place, date] -----> If executed in Quezon City but law office is in Makati, Q.C for
Makati City

ATTY. JUAN DELA CRUZ

Counsel for: [Plaintiff]
Address
IBP, PTR, MCLE nos.
*Copy furnished if not an initiatory pleading

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, _______________________, of legal age, after having been duly sworn in
accordance with law, depose and state that:
1. I am a plaintiff in the above-stated case;
2. I caused the preparation of the foregoing complaint;
3. I have read the contents thereof and the facts stated therein are true and correct
of 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.
ROGER FEDERER
Affiant
SUBSCRIBED AND SWORN to before me this ___ day of __________ 200_ at
_________________ affiant exhibiting to me his Community Tax Certificate
No.____________________ issued on ________________ 200_ at ______________
City (Government issued ID).

ATTY. PEDRO DELA CRUZ

Notary Public
Comm. Expires on 31 December 2015
P.T.R. No.
I.B.P. No.

Doc. No. ;
Page No. ;
Book No. ;
Series of 200_.