Republic of the Philippines

REGIONAL TRIAL COURT

8th Judicial Region
OFFICE OF THE EXECUTIVE JUDGE
Ormoc City
IN THE MATTER OF THE
PETITION FOR RENEWAL OF COMMISSION
AS NOTARY PUBLIC FOR THE
CITY OF ORMOC AND CITIES/MUNICIPALITIES
OF ______________UNDER THE
TERRITORIAL JURISDICTION OF THIS
HONORABLE COURT

Notarial Commission No. : __________

BENJAMIN S. PONGOS, JR.
Petitioner.
x----------------------------------------x
1.

PETITION

PETITIONER, BENJAMIN S. PONGOS, JR. to this Honorable Court, most

respectfully files this petition/application for renewal of her Commission as a
Notary Public for the province and in the City of Ormoc, for a term commencing
on Jan. 1, 2017 and ending on Dec. 31, 2018. In support of this petition, he states,
that:

1. He was previously granted a Notarial Commission by Order dated ______

signed by then Executive Judge ____________________. Attached is a copy
of the Order marked as Annex A.
2. He possesses the eligibility for commissioning as Notary Public as shown by
his following personal circumstances:

1.

Nationality : Filipino

2.

Date/ Place of Birth : January 31, 1968/ Ormoc City

3.

Residence : No. 611 Bonifacio Extension, Brgy. District 18,

Ormoc City, Leyte

4.

Telephone No. : 09189389579

5.

PTR Number :

6.

Roll of Attorney No. : 49917,

7.

IBP Number :

3. He has satisfactorily completed the required course in law at Southwestern

University

on

___________;

_________________

and

passed

admitted

to

the
the

Bar

Examinations

practice

of

law

________________;

4. He holds office at the following address:

No. 611 Bonifacio Extension, Brgy. District 18, Ormoc City, Leyte

of
in

5. That he is a resident of the Philippines since birth;

6. He has not been convicted, much less, charged with any offense involving
moral turpitude;
7. He is a member of good standing of the Philippine Bar as shown by the
following certification:
1.

Certification of No Pending Administrative Case issued by the

Bar Confidants Office of the Supreme Court, Manila (Annex B),
2.
Certification of No Criminal Case filed against her issued by
the Office of the Clerk of Court, Regional Trial Court, Ormoc City
(Annex C).
3.
Certification as a Member of Good Standing issued by the IBPLeyte Province Chapter (Annex D).
8. Three of his identification pictures with corresponding signatures at the bottom
are attached in this petition;
9. He has not applied for nor was he issued a Commission as a Notary Public in
any other jurisdiction for the current year;
10. Attached hereto is a separate sheet of paper and forms part of this petition
containing three (3) specimens of petitioners signature.
11. He undertakes to submit or report to the Office of the Clerk of Court copies of
all deeds notarized by him.

SUBMITTED. Dec. ___, 2016, Ormoc City, Philippines.

BENJAMIN S. PONGOS, JR.

No. 611 Bonifacio Extension, Brgy. District 18,
Ormoc City, Leyte
Roll of Attorneys No. 49917

IBP No. _____ , _____, ___________

PTR No. ______, ________

VERIFICATION
I, BENJAMIN S. PONGOS, JR., Filipino, of legal age, single and a resident of
No. 611 Bonifacio Extension, Brgy. District 18, Ormoc City, Leyte after being duly
sworn to in accordance with law hereby state:
1.

That I am the petitioner of the above instant case.

2.

That I have caused the preparation of the above-entitled petition.

3.

4.

That I have read the same and that it is true and correct based on my
personal knowledge or based on authentic records.
That I hereby certify under oath in this petition as follows:
a. I have not theretofore commenced any action or filed any action or claim
involving the same issue in any court, tribunal or quasi-judicial agency and,
to the best of my knowledge, no such other pending action or claim is
pending therein;

b.

If there is such other pending action or claim, a complete statement of the

present status thereof; and

c.

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 therefrom to the
court wherein the aforesaid complaint or initiatory pleading has been filed.

IN WITNESS WHEREOF, I have hereunto affixed my signature this, Ormoc City,

Philippines.

BENJAMIN S. PONGOS, JR.

SUSBCRIBED AND SWORN TO before me, a notary in the City of Ormoc,
personally
appeared
above
name
with
his
___________________________________ as shown above, who is personally
known to me to be the same and/ or identified through competent evidence of
identity as defined by Rules on Notarial Practice, who presented the foregoing
instrument and signed the instrument in my presence, and who took an oath before
me as to such instrument.
Witness my hand and seal this December _____.

Doc. No.
Page No.
Book no.
Series of