Republic of the Philippines )
City of [Place of Notarization] ) S.S.
VERIFICATION & CERTIFICATION
I, (NAME OF AFFIANT), Filipino, of legal age, single/married, and a resident of (Residence of Affiant), Philippines, after having been duly sworn in accordance with law, hereby depose and state that:
I am the Petitioner/Plaintiff in the above entitled case and have caused the preparation of the foregoing Petition/Complaint and that based on my own personal knowledge and on authentic documents, the facts stated therein are true and correct.
This Petition/Complaint is not filed to harass, cause unnecessary delay, or needlessly increase the cost of litigation; and the factual allegations therein have evidentiary support or, if specifically so identified, will likewise have evidentiary support after a reasonable opportunity for discovery.
I hereby certify that I have not theretofore commenced any action or filed any claim of a similar nature or involving the same issues in any office, court, or with the Court of Appeals or the Supreme Court or any tribunal, government agency or instrumentality for that matter, and to the best of my knowledge, no such other pending action or claim is pending therein; and
If I should thereafter learn of any such case being pending or filed with such agencies or courts abovementioned, I undertake to inform the Honorable Court or any government instrumentalities having jurisdiction of this case of the existence or pendency of such proceeding or action, within five (5) calendar days from knowledge of such fact.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date of Filing) in (Place of Filing), Philippines.
(NAME OF AFFIANT)
ID Details of Affiant
SUBSCRIBED AND SWORN to before me, a notary public in and for (Place of Notarization), this (Date of Notarization) at (Place of Notarization), personally appeared (NAME OF AFFIANT), known to me to be the same person who presented the foregoing instrument, and who has satisfactorily proven to me his/her identity by presenting to me his/her ID described above, which is an identification card duly issued by a government agency and which bears the signature and photograph of the party, and he/she signed the instrument in my presence and took an oath before me as to such instrument.
WITNESS MY HAND AND SEAL on the date and place first above written.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of ____.
