Republic of the Philippines

REGIONAL TRIAL COURT

8TH Judicial Region
Bulwagan ng Katarungan
Magsaysay Boulevard, Tacloban City
PETITION FOR APPOINTMENT AS
NOTARY PUBLIC FOR AND WITHIN
THE TERRITORIAL JURISDICTION
OF THE REGIONAL TRIAL COURT
OF TACLOBAN CITY, LEYTE

NC____________________

ATTY.
Petitioner
x---------------------------------x
PETITION
COMES NOW, petitioner and unto this Honorable Court, most
respectfully files this petition for renewal of her Commission as a Notary
Public and further avers:
1. She was previously granted a Notarial Commission by Executive
Judge Alphinor Serrano with __________________. Attached is a
copy of the Certification marked as Annex A.
2. That she possesses the eligibility for commissioning as Notary
Public as shown by her following personal circumstances:
a. Nationality
: Filipino
b. Date/ Place of Birth : ____________/________________
c. Residence
:
d. Mobile No.
:
e. PTR Number
:
f. Roll of Attorney No. :
g. IBP Number
:
h.
3. That she maintains a regular
158______________________

place

of

work

at

4. That she is a member of the Philippine Bar, having been admitted

to practice law in all courts of the Philippines, in good standing with
clearances from the Office of the Bar Confidant of the Supreme
Court and the Integrated Bar of the Philippines hereto attached as
Annexes B (Certificate of Membership in the Philippine Bar) C
(Certification from the Office of the Bar Confidant) and D

(Certification from the Integrated Bar of the Philippines Leyte

Chapter).
5. That she has never been convicted of any crime whatsoever
involving moral turpitude. Attached hereto is the Clearance issued
by the National Bureau Investigation as Annex E.
6. That she possesses all the qualifications and none of the
disqualifications to be commissioned as Notary Public;
7. That she desires to be commissioned as Notary Public for and
within the Province of Leyte including the City of Tacloban;
8. That her Commission
____________________

as

Notary

Public

will

expire

on

9. Attached hereto is a separate sheet of paper and forming part of

this petition containing three (3) specimens of petitioners
signature and identification photographs.
WHEREFORE, premises considered, it is most respectfully prayed of
this Honorable Court that she be commissioned as Notary Public for and
within the Province of Leyte including the City of Tacloban.
BULWAGAN NG KATARUNGAN, Magsaysay Boulevard, Tacloban
City, Philippines, December 23, 2016.

ATTY.
Petitioner

Republic of the Philippines

City of Tacloban
s.s.
x-----------------------------x
VERIFICATION AND CERTIFICATE OF NON-FORUM SHOPPING
I, ___________________________, after being duly sworn in
accordance to law, hereby depose and say:
1. That I am the petitioner in the above-entitled case;
2. That I have caused the above petition to be prepared and have read
and know the contents thereof; and that allegations therein are true of
my personal knowledge;
3. That I have not commenced any action or filed any claim involving the
same issues on any court, tribunal, or quasi-judicial agency, and no
such other action or claim is pending therein;
4. That if there is such other action or claim a complete statement of the
status thereof will be furnished to this court by me; and
5. That if I should thereafter learn that the same or similar action or
claim has been filed or is pending, I shall report that fact within five
(5) days there from to this Honorable Court.

ATTY. ___________________
Petitioner
SUBSCRIBED AND SWORN to before me, a notary public for the
Province of Leyte, this _________________here in Tacloban City, with
evidence of identity: Roll of Attorneys No. ___________________
Doc. No. ____
Page No. ____
Book No. ____
Series of 201

PETITIONER _________________
SPECIMEN SIGNATURE

__________________________

__________________________

___________________________

THREE 2x2 ID COLOR PHOTOGRAPHS