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REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT


NATIONAL CAPITAL JUDICIAL REGION
MAKATI CITY

IN RE: PETITION FOR COMMISSION


AS NOTARY PUBLIC IN THE
CITY OF MAKATI

____________
Petitioner
x-----------------------------------------------------------x

PETITION

Petitioner, _________, (hereinafter “Petitioner”) respectfully states:

1. Petitioner is of legal age, Filipino and holding office


______________________.

2. Petitioner is a member of the Philippine Bar having been admitted to the


practice of law on ___, 2010 as evidenced by a photocopy of his Certificate of
Membership attached hereto and made an integral part hereof as Annex “A”.

3. Petitioner has not been accused of any crime involving moral turpitude
before any court or tribunal in the Philippines.

4. Petitioner is not a member of any subversive association or any association


advocating to overthrow the existing government.

5. Petitioner is not a government employee nor has he applied for the same
commission in any other jurisdiction.

6. Petitioner has paid his membership fee with the Integrated Bar of the
Philippines as per IBP Official Receipt No. ___________ dated ________, 2010, a
photocopy of which is attached hereto as Annex “B”. He has also paid the Professional
Tax Receipt due his as evidenced by PTR No. ___________ dated _________, 2010
a photocopy of which is also attached herewith as Annex “C”.
7. The true impression of Petitioner’s notarial seal is attached to this Petition
together with the three specimens of his signature as Annexes “D” and “E” respectively.

PRAYER

WHEREFORE, petitioner respectfully prays that he be commissioned as Notary


Public for the City of Makati.

Respectfully submitted.

Makati City, August 3, 2010.

NAME
PTR No. _______/7-28-10/Makati City
IBP No. _______/4-28-10/Quezon City

REPUBLIC OF THE PHILIPPINES)


City of Makati ) S.S.

VERIFICATION

I, NAME, of legal age with address at _________, depose and state:

1. I am the Petitioner in the above Petition.

2. I have caused the preparation of the foregoing Petition.

3. I certify that I have read and understood the contents thereof and verify that
the facts stated therein are true and correct based on my personal knowledge
and authentic records.

Affiant further sayeth naught.


NAME

SUBSCRIBED AND SWORN to before me this ____ day of August 2010, affiant
exhibiting to me his Driver’s License No. __________ issued by the Land
Transportation Office of Quezon City and which will expire on ______, 2011.

Doc. No.
Page No.
Book No.
Series of 2010.
Annex “E”

Three (3) specimens of his signature:

_________________________

_________________________

_________________________
[c] His Office Address:
Annex “D”
Annex “C”

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