PETITION FOR CERTIORARI

PETITIONER, thru counsel, respectfully avers that:

1. (State the capacity and residence of the petitioner and the

respondent)

2. (State that facts and circumstances under which the

respondent (tribunal, board, or officer exercising judicial functions)
has acted without, or in access of its jurisdiction.)

3. (State that there is no appeal from such decision, nor any plain,
speedy, and adequate remedy in the ordinary course of law.)

4. That a certified true copy of the decision (or order) herein

sought to be reviewed is here attached as ANNEX "A," together with
copies of all pleadings and documents relevant and pertinent thereto.

WHEREFORE, It is respectfully prayed that a writ of certiorari

be issued, ordering the proceedings herein complained to be
forthwith certified upon for review (with prayer for a preliminary writ
of injunction as the case may be, for the protection of the rights of
petitioner pending such proceedings), and after due hearing, let
judgment be rendered annulling or modifying the proceeding if (the
defendant tribunal, board or officer) as the law requires, with costs.

Incidental reliefs as law and justice may require are likewise

prayed for.

(Veneue, date, signature)

(VERIFICATION /CERTIFICATION OF NON-FORUM SHOPPING)