Republic of the Philippines

REGIONAL TRIAL COURT

SECOND JUDICIAL REGION
Branch 25
Bulanao, Tabuk City, Kalinga

IN RE: PETITION FOR REAPPOINTMENT AND RECOMMISSION AS

NOTARY PUBLIC FOR THE CITY OF TABUK AND KALINGA
PROVINCE UNDER THE TERRITORIAL JURISDICTION OF THIS
HONORABLE COURT

Application No. : __________

ATTY_______________________________________
Petitioner.
x----------------------------------------x

PETITION

PETITIONER, ATTY___________________________ to this

Honorable Court, most respectfully files this petition/application for
renewal of his Commission as a Notary Public for the City of Tabuk
and for the Province of Kalinga, for a term ending on December 31,
2020. In support of this petition, he states, that:

1. He was previously granted a Notarial Commission by

CERTIFICATE OF AUTHORITY FOR A NOTARIAL ACT dated
September 5, 2017 signed by Judge ______________________.
.
Attached herein and form part of his petition is a copy of the
CERTIFICATE OF AUTHORITY FOR A NOTARIAL ACT marked
as Annex “A.”

2. He is a member of good standing of the Philippine Bar as

shown by the following certifications/clearances attached and
formed part of his petition:

a. Court Clearance issued by the Office of the Clerk of

Court, Regional Trial Court, Tabuk City, Kalinga dated
December 12, 2018 certifying that there is no criminal,
civil nor administrative case against him before said
Office (Annex “B”);

b. Certification issued by the Office of the Bar

Confidant of the Supreme Court, Manila certifying that
there is No Pending Administrative Case against him
before said Office (Annex “C”);

1
 c. Two Certifications issued by the IBP Kalinga-Apayao
Chapter certifying him as a Member in Good Standing
and further certifying that there is No Pending
Administrative nor Disbarment Case against him
(Annex “D” and Annex “E”);

d. MULTI-PURPOSE CLEARANCE issued by the

National Bureau of Investigation remarking that he has
no record on file before said Office (Annex “F”)

3. Attached hereto is the true impression of his dry seal and

made an integral part of his Petition as Annex “G”.
Further attached herein as Annex “H” and is also made
an integral part of his Petition is the copy of the
CERTIFICATE OF AUTHORIZATION FOR HIM TO
PURCHASE A NOTARIAL SEAL signed by
Judge_______________ on September 5, 2017;

4. He has not applied for nor was he issued a Commission as a

Notary Public in any other jurisdiction for the current year.

PRAYER

WHEREFORE, P e t i t i o ne r m o s t re s p e c t fu l l y p r a ys th a t
he be reappointed and re-commissioned as Notary Public for
and in the City of Tabuk and Kalinga Province under the
Territorial Jurisdiction of this Honorable Court for a term
ending on December 31, 2020.

Such other reliefs as just and equitable under the premises

are likewise prayed for.

Respectfully Submitted.

Bulanao, Tabuk City, Kalinga this 14th day of December, 2018.

ATTY. xxxxxxxxxxxx
Petitioner
Roll No. __________
PTR No. __________
IBP No. _______________
MCLE (_______________
Purok 1, Bulanao, Tabuk City, Kalinga

2
Republic of the Philippines)
Tabuk City ) S.S
Province of Kalinga )

VERIFICATION/CERTIFICATION AGAINST FORUM-SHOPPING

I, ___________________________, Filipino, of legal age, single, and

a resident of Purok 1, Bulanao Centro, Tabuk City, Kalinga, after
having been sworn to in accordance with law, depose and state
that:

1. I am the Petitioner in the aforementioned petition and that I

have caused the preparation of the same;

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

14th day of December, 2018, at Tabuk City, Kalinga.

_________________________________
Affiant

SUBSCRIBED AND SWORN TO, before me this 14th day of

December, 2018 at Tabuk City, Kalinga.