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Republic of the Philippines

REGIONAL TRIAL COURT


8th Judicial Region
Branch 10
Abuyog, Leyte

IN THE PETITION FOR COMMISION

AS NOTARY PUBLIC IN AND FOR THE

PROVINCE OF LEYTE

ATTY. REX L. FLORES,

Petitioner.

x------------------------------------------------------------x

PETITION
Petitioner, to this Honorable Court, respectfully states that:

1. He is of legal age, having been born on September 29, 1990, single, Filipino
citizen and presently residing at Brgy. Capudlosan Macarthur, Leyte;

2. He has been admitted to the practice of law in the Philippines as shown by the
Certificate of Admission to the Philippine Bar, which contains the Petitioners
Roll of Attorney No. 62002. A copy of the Certificate of Admission to the
Philippine Bar is attached and marked as Annex A hereof;

3. He is a member of good standing of the Philippine Bar as shown by the clearance


issued by the Office of the Bar Confidant of the Supreme Court a copy of which is
attached as Annex B hereof;

4. He is likewise a bona fide member of the Integrated Bar of the Philippines. A


photocopy of his IBP Receipt showing his IBP No.934935 is attached and marked
as Annex C hereof. Also attached and mark herewith as Annex D is the
Certificate of petitioners good moral character issued by
Atty.____________________ and Atty. ____________________, President and
Secretary, respectively, of IBP LEYTE Chapter;

5. He has also paid the Professional Tax Receipt due him as evidenced by PTR No.
________, dated __________, a photocopy of which is also attached herewith as
Annex E;

6. He has all the qualifications and none of the disqualifications for the Office of the
Notary Public;

7. He has never been charged nor convicted of any crime involving moral turpitude;
8. He has no commission as notary public in any other jurisdiction;
9. He has attached hereto in a separate sheet of paper specimen of his official
signatures and marked as Annex F and made an integral part hereof;

10. He has likewise attached thereto his three (3) passport size photographs each
bearing his signature on the bottom part thereof as Annex G hereof;

11. He has been issued an Appointment as Notary Public by this Honorable Court on
_________ which appointment ends on __________, attached herewith is the said
Appointment as Annex H , and a true impression of his notarial dry seal made
pursuant to law as Annex I , respectively; and

WHEREFORE, Petitioner respectfully prays that He be commissioned as Notary


Public for and in the Province of Leyte.

Respectfully submitted.

Abuyog, Leyte, Philippines.

Petitioner

Roll No;
Page No;
Book No. I
IBP No. 934935 Leyte-Chapter
PTR No.
Republic of the Philippines )

Province of Leyte ) S.S

Abuyog, Leyte )

x------------------------------------------------x

VERIFICATION
I, Atty. Rex L. Flores, Filipino, of legal age, single and a resident of Brgy.
Capudlosan Macarthur, Leyte, after having duly sworn to in accordance with law, do
hereby depose and say that:

1. I am the petitioner in the above-entitled Petition;


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

IN WITNSESS WHEREOF, I have hereunto affixed my signature this ______


day of ______, 2017, at Abuyog, Leyte, Philippines.

Petitioner-Affiant

SUBSCRIBED AND SWORN TO BEFORE ME in the City of


______________ this______ day of______, 2013 by ______________, a person known
to me and to me known to be the same person who personally signed before me the
foregoing Petition and acknowledged that she executed the same, and exhibiting to me
her _______ as competent proof of her identity.

_____________________
Administering Officer

Doc. No. ______;


Page No. ______;
Book No. ______;
Series of 2013.

ANNEX A
CERTIFICATE OF MEMBERSHIP IN THE PHILIPPINE BAR (PHOTOCOPY)
ANNEX B

CERTIFICATE OF GOOD STANDING FROM OBC


ANNEX C

PHOTOCOPY OF IBP RECEIPT


ANNEX D

CERTIFICATE OF GOOD MORAL CHARACTER

FROM IBP LEYTE CHAPTER

INTEGRATED BAR OF THE PHILIPPINES

LEYTE Chapter

Tacloban, City

CERTIFICATION
THIS IS TO CERTIFY that ATTY. Rex L. Flores of Macarthur, Leyte is a
Member of the Integrated Bar of the Philippines per his IBP No. ______ and is a bona
fide member of the Integrated Bar of the Philippines, ______Chapter, Philippines.

This certification is issued upon the request of ___________ for all legal intents
and purposes.

___________, Philippines, ___________.

ATTY._______________________

Chapter Secretary

ATTY.__________________
_____

Chapter President
ANNEX E

PHOTOCOPY OF PTR RECEIPT


ANNEX F

SPECIMEN SIGNATURES OF ATTY.

1. __________________________________

2. __________________________________
ANNEX G

PHOTOGRAPH WITH SIGNATURE


ANNEX H

Republic of the Philippines

REGIONAL TRIAL COURT

8th Judicial Region

OFFICE OF THE EXECUTIVE JUDGE

Abuyog, Leyte

APPOINTMENT

BE IT KNOWN THAT:

ATTY. Rex L. Flores is a resident of Brgy. Capudlosan MacArthur,

Leyte, Philippines, is appointed by me as NOTARY PUBLIC for and within the Province

of Leyte, Philippines, for a term starting from the ____________________ day of

__________ to _____________of ____________ Anno Domini, Two Thousand

Seventeen (2017).

GIVEN UNDER MY HAND and caused the Seal of this Court to be

affixed thereon, this____ day of ___, Anno Domini, Two Thousand Seventeen (2017) at

the Abuyog, Leyte, Philippines.

Executive Judge
ANNEX I

TRUE IMPRESSION OF THE NOTARIAL DRY SEAL OF ATTY.