Republic of the Philippines)

X - - - - - - - - - - - - - - - - - x) S.S.
City of Baguio - - - - - - - - )
VERIFICATION
I, ____of legal age, Filipino and a resident of _____, after having been duly
sworn to in accordance with law, hereby depose and state:
That I am the Complainant/Petitioner in the above entitled case;
That I caused the preparation of the foregoing Complaint/Petition.
That I have read and understood the allegations contained therein and that the
same are true and correct to the best of my knowledge and belief.
IN WITNESS SWHEREOF, I have hereunto set my hand this ___th day of
December, 2005, in the City of Baguio, Philippines.
_______________________
(Affiant-Complainant/petitioner)

SUBSCRIBED AND SWORN to before me this ___th day of December, 2005, in

the City of Baguio, Philippines, affiant exhibited to me his CTC No. 12345676, issued at
Baguio City, on January 2, 2005.
JUAN DE LA CRUZ
Notary Public
Until December 31, 2005
IBP NO. 0000001123- 1-05-2005
Baguio City
Doc. No. _____ ;
Page No. _____:
Book No. _____;
Series of 2005.

CERTIFICATE OF NON-FORUM SHOPPING

I.

II.

Certify that I have not commenced any action involving the same
issues, before the Supremem Court, Court of Appeals or any
division thereof or any tribunal or agency, to the best of my
knowledge no such action is pending before the Supreme Court,
Court of Appeals or any tribunal or agency; and
That in the event that any action involving the same should be
made known, I bind myself to report the same within five (5) days
from knowledge thereof to this Honorable Court.
IN WITNESS WHEREOF, I hereunto set my hand this ___th day
of December, 2005, at Baguio City, Philippines.
UNCLE SAM
(Affiant)
SUBSCRIBED AND SWORN To before me this ___thd day of
December, 2005, in the City of Baguio, affiant exhibited to me his
CTC No. 1234567, issued at Baguio City, on January 2, 2005.

JUAN DE LA CRUZ
Notary Public
Until December 31, 2005
PTR No. 12345667- 1-5-2005

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2005.

Republic of the Philippines)

X - - - - - - - - - - - - - - - - - -) S.S.
City of Baguio - - - - - - - - )

VERIFICATION AND CERTIFICATION

I, _______________, Filipino, of legal age, and with residence and postal
address at No. ____, Baguio City, after having been duly sworn to in accordance with
law, do hereby depose and state:
That I am the complainant/Petitioner in the above entitled case;
That I caused the preparation of the foregoing complaint/petition; That I have
read the allegations therein and certify that the same are true and correct of my own
personal knowledge and belief;
That I further certify that I have not commenced any other action involving the
same issues, before the Supreme Court, Court of Appeals or any tribunal or agency; to
the best of my knowledge no such action is pending before the Supreme Court, Court of
Appeals or any tribunal or agency; and
That in the event that any action involving the same should have been made
known, I hereby bind myself to report the same within five (5) days from knowledge
thereof to this Honorable Court.
IN WITNESS WHEREOF, I have hereunto set my hand this ___th day of
December, 2005, in the City of Baguio, affiant having exhibited to me his CTC No.
1234567, issued at Baguio City on January 2, 2005.

JUAN DE LA CRUZ
Notary Public
Until December 31, 2005
PTR No. 12345678 -1-2-2005

Doc. No. _____;

Page No.--------;
Book No._____;
Series of 2005.