REPUBLIC OF THE PHILIPPINES )

CITY OF BATANGAS ) S.S.

VERIFIED DECLARATION

I, ______________________, of legal age, single, and with office address at

st
1 Flr., Naty Sangalang Bldg., C. Tirona St., Batangas City, hereby depose and
state:

1. I am one of the counsels of Anthonel M. Miñano who filed a petition for

certiorari before the Honorable Supreme Court.

2. I hereby declare the documents and annexes of GR No. 226338, entitled

Anthonel M. Miñano vs. Sto. Tomas General Hospital and Dr. Nemesia
Roxas-Platon, submitted electronically via email last September 2, 2016
in accordance with the Efficient Use of Paper Rule and the Rules on E-
Filing are complete and true copies of the documents and annexes filed
with the Supreme Court.

IN WITNESS WHEREOF, I hereunto affixed my signature this

________________, at Batangas City, Philippines.

___________________________
Tax Identification No.

SUBSCRIBED AND SWORN to before me this ____________________,

affiant personally known to me who exhibited to me her competent evidence of
identity printed below her name and signature.

Doc. No._________;
Page No. ________;
Book No.________;
Series of 2017.