Republic of the Philippines )

Tabuk City ) S.S

Province of Kalinga )

VERIFICATION/CERTIFICATION AGAINST FORUM-SHOPPING

I, , of legal age, married, Filipino citizen, and presently residing

at Asibanglan, Pinukpuk, Kalinga, after having been sworn to in
accordance with law, depose and state that:

1. I am the defendant in the aforementioned Civil Case No.

and that I have caused the preparation of this Answer;

2. I have read and understood the contents hereof and hereby

attest that the same are true and correct of my own
personal knowledge or based on authentic records;

3. I have not filed any action involving the same issue before
the Court of Appeals, Supreme Court or any other court,
tribunal or agency;

4. There is no action involving the same issue before the Court

of Appeals, Supreme Court or any other court, agency or
tribunal;

5. Should I learn that any such action is filed or pending

before any court or tribunal or agency, I shall inform this
Honorable Court within five (5) days from knowledge
thereof.

IN WITNESS WHEREOF, I have hereunto set my hand this

_______________, at BulanaoTabuk City, Kalinga.

Affiant

SUBSCRIBED AND SWORN TO, before me this

__________________ at BulanaoTabuk City, Kalinga.