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NOTARIAL COMMISSION FOR AND IN THE CITY OF _____ ____________________ Application # ____________ Petitioner. x- - - - - - - - - - - - - - - - - - - - - - - - - x

The undersigned petitioner, _______________, unto this Honorable Court respectfully states that: 1. She is a Filipino citizen, married, over twenty one (21) years old and a resident of ________________, copies of the picture of the petitioner with signature at the bottom part are hereto attached as Exhibits A, A-1 and A-2; 2. She has completed her law studies at _____________; 3. She has her office located at ______________________, copies of the picture of the office are attached hereto as Exhibits B and B-1; 4. She was admitted to the Philippine Bar on ________________, a copy of the certificate of admission is hereto attached as Exhibit C; 5. She has acquired her clearance from the Regional Trial Court from _________ , hereto attached as Exhibits G; 6. She has no pending administrative case as evidenced by the certification issued by the Office of the Bar Confidant which is hereto attached as Exhibit H; 7. She is a bona fide member in good standing of the Integrated Bar of the Philippines, ______ Chapter, attached is a copy of his Certificate of Good Standing as Exhibit D, and has paid her membership due on _______ as evidenced by IBP Official Receipt ______ issued by the Integrated Bar of he Philippines, hereto attached are copies as Exhibits E and E-1; 8. That she has completed the required units in compliance with the Mandatory Continuing Legal Education as mandated by the Supreme Court. Attached herewith is a copy of her MCLE Compliance Certificate as Exhibit F

9. She has paid her Professional Tax for the fiscal year _____ under Professional Tax Receipt _______, a copy is hereto attached as Exhibit G; 10. She has attached herewith and made integral parts hereof his specimen signatures and the true impressions of his dry seal as Exhibits H, H-1, H-2 and I, I-1 and I-2; 11. She possesses all the qualifications and none of the disqualifications of a Notary Public; 12. She has not applied for commission before any other jurisdiction; 13. She undertakes to inform the Executive Judge within ten (10) days in case of any change in the given address and to submit her monthly report religiously; 14. She now desires to be granted Notarial Commission as Notary Public for and in the City of _____.

WHEREFORE, in view of the foregoing, it is respectfully prayed of this Honorable Court, after due notice, publication and hearing to grant this Petition for Appointment of Notarial Commission of the herein Petitioner for and in the City of _______________. Other just and equitable reliefs are likewise prayed for. Date . ______City.

________________________________ Petitioner

REPUBLIC OF THE PHILIPPINES) ________ CITY. . . . . . . . . . . . . . . )S.c.


I, ___________, of legal age, married, Filipino and a resident of ___________, under oath depose and state that: I am the Petitioner in the above captioned case; I have caused the preparation of the same; I have read the allegations contained therein; and I certify that they are all true and correct to the best of my own knowledge. I further certify under oath that I have not commenced any similar action before the Supreme Court, Court of Appeals, or before any court, tribunal or agency concerned; and should I learn of any similar cause of action filed before any of the aforesaid bodies, I undertake to notify this Honorable Court within five (5) days from notice. In witness whereof, I have hereunto set my hand this _____, at ____ City.

______________________________ Affiant SUBSCRIBED AND SWORN TO before me this __th day of _____ at Taguig City, Philippines. Affiant exhibited to me her IBP ID.