ACKNOWLEDGMENT OF INSTRUMENT CONSISTING OF TWO OR MORE PAGES
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF ______________ ) S.S. MUNICIPALITY OF _____________)
BEFORE ME this _____ day of _______________, 2001 in the Municipality of _________________, Province of ____________, Philippines, personally appeared ______________________, with Community Tax Certificate No. _________ issued at ________________ on ________________ and T.I.N. No. ________, known to me to be the same person who executed the foregoing instrument, and he acknowledged to me that the same is his free act and deed.
This instrument, consisting of _____ pages, including the page on which this acknowledgement is written , he has been signed on the left margin of each and every page thereof by __________________ and his witness, and sealed with my notarial seal.
IN WITNESS WHEREOF, I have hereunto set my hand, the day, the year, and the place above written.
NOTARY PUBLIC
My Commission expires Dec. 31, 2001 IBP No. ______, 1/2/2001, Pasig City P.T.R. No. ____, 2/2/2001, Pasig City
Doc. No. _____; Page No. _____; Book No. _____; Series of 20____
JURAT
SUBSCRIBED AND SWORN to me, in the Municipality of ________, this ____th day of ______, 19 ____ by, _______ with Community Certificate No. _____ issued at _____ on ______, 2001.
NOTARY PUBLIC
My Comission expires Dec. 31, 2001 IBP No. ______, 1/2/2001, Pasig City P.T.R. No.____, 2/2/2001, Pasig City
Doc. No._____; Page No._____; Book No._____; Series of 20____.
VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING
VERIFICATION
JUAN DELA CRUZ, subscribing under oath, hereby deposes and states that:
I am the petitioner in the instant case.
I have read the foregoing Petition and the allegations therein are true and correct of my own knowledge and/or based on the records on hand.
I attest to the authenticity of the annexes thereof.
CERTIFICATION
I certify that:
a. I have not commenced any other action or proceeding involving the same issues in the Supreme Court, the Court of Appeals, or different Divisions thereof, or any other tribunal or agency.
b. No such action or proceeding is pending in the Supreme Court, the Court of Appeals, or different Divisions thereof, or any other tribunal or agency.
c. If I should learn that a similar action or proceeding has been filed or is pending before the Supreme Court, the Court of Appeals, or different Divisions thereof, or any other tribunal or agency, I hereby undertake to notify this Honorable Court within five (5) days from such notice.