Republic of the Philippines

NATIONAL CAPITAL JUDICIAL REGION

OFFICE OF THE CLERK OF COURT
REGIONAL TRIAL COURT
Branch No.___
Makati City

RE: PETITION FOR

APPOINTMENT AS
NOTARY PUBLIC FOR
AND IN THE
JURISDICTION OF
NATIONAL CAPITAL
JUDICIAL REGION IN
MAKATI CITY

[Name]
Petitioner

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

PETITION

COMES NOW, the undersigned Petitioner, of legal age,

with office address at the [Address] unto this most
Honorable Court, respectfully avers, that:

1. Petitioner is a citizen and a resident of the

Republic of the Philippines and was born on ____
at ___;
2. Petitioner has satisfactorily completed the [Law
Degree] at the [Law School];
3. The undersigned petitioner passed the bar and
was admitted to the practice of law on _____ and
currently holds a [Office Position] at the [Office
and Office address];

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 4. Petitioner is a member of the Philippine Bar in
good standing as certified by the Office of the
Bar Confidant that he has no pending
administrative case filed against him. Attached
is the clearance issued by the Office of the Bar
Confidant, marked as Annex “A”;
5. Petitioner is a bona fide member of the IBP Rizal
Chapter in good standing, having no unpaid
dues and fees. Attached is the clearance issued
by the Integrated Bar of the Philippines (IBP)
Rizal Chapter, marked as Annex “B”;
6. Petitioner has no derogatory record in the
National Bureau of Investigation (NBI).
Attached is the NBI clearance valid until
___________, marked as Annex “C”;
7. Further attached is the imprint of the dry seal
and the specimen signatures of the Petitioner
marked as Annexes “D” and “E”;
8. Likewise attached hereto are three (3) copies of
passport size picture, sketch location of office,
and photocopy of his office, marked as Annexes
“F”, “G”, “G.1”, “G.2”, “G.3”, “G.4”
respectively;
9. Petitioner is a member of the Philippine Bar,
having been admitted on _____. Attached is the
original certification of membership in
Philippine Bar by the Office of the Bar Confidant
marked as Annex “H”;
10. Further applicant/petitioner paid his dues with
the Integrated Bar of the Philippines, attached is
a copy of IBP receipt issued by IBP Makati
marked as Annex “I”;
11. Furthermore applicant/petitioner paid the
Professional Tax, and attached is the Official

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 Receipt issued by the City of Makati marked as
Annex “J”;
12. The undersigned has not been convicted in the
first instance of any crime involving moral
turpitude and has read and fully understood the
Rules on Notarial Practice;
13. Undersigned petitioner desires to approve his
application for commission as Notary Public for
and within the jurisdiction of Makati.
Undersigned further states that he possesses all
the qualifications and none of the
disqualifications for said office.

WHEREFORE premises considered it is most

respectfully prayed of this Honorable Court that the
notarial commission for and within the jurisdiction of
MAKATI be approved and issued to undersigned
applicant/petitioner.

Respectfully submitted.

2019 March, Makati City, Philippines.

List of Annexes

Annex A - Certification of the Office of the Bar Confidant

Annex B - Certification of bona fide lifetime membership in IBP Rizal
Chapter
Annex C - NBI Clearance
Annex D - Dry Seal Imprint
Annex E - Specimen Signatures
Annex F - 3 copies of passport size picture with signature
Annex G - G.4 Office pictures
Annex H - Certification of membership in Philippine Bar
Annex I - IBP Lifetime Membership Receipt
Annex J - PTR Receipt copy

[NAME]

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 [LAWYER DETAILS]

VERIFICATION AND CERTIFICATION

AGAINST FORUM SHOPPING

I, __, under oath, depose and state that:

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

2. I have caused the preparation of the foregoing Petition
3. The allegations therein are true and correct based on
my personal knowledge and authentic records;
4. To the best of my knowledge, there are no other
pending petitions of the same nature before any court,
tribunal or quasi-judicial agency; and
5. Should I thereafter learn of any similar case pending
before any other court, tribunal or quasi-judicial
agency, I shall promptly notify this court within 5 days
from discovery.

________________
[NAME]

JURAT

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 SUBSCRIBED AND SWORN to before me in the
__________ on this day of _______________ 2019, affiant
exhibiting before me his ___.

NOTARY PUBLIC

Doc. No. ______;

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

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