REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

NATIONAL CAPITAL REGION
CITY OF MANILA

IN RE: PETITION FOR APPOINTMENT

AS NOTARY PUBLIC FOR AND
IN THE CITY OF MANILA

_________________________
Petitioner.
x-------------------------------------------------x

PETITION

Petitioner, _______________________________, respectfully states that:

1. She is of legal age, Filipino citizen, with office address at

___________________________________. Her home address is at
___________________________________________________

2. Petitioner obtained her Bachelor of Laws degree from

_____________________________________________. She is a member in
good standing of the Philippine Bar, having passed the Bar
Examinations given in September 2007 and admitted to the practice
of law on 02 May 2008, as shown by a Certification of the Office of
Bar Confidant of the Supreme Court, a copy of which is attached
hereto as Annex “A”.

3. She has paid her professional tax for the year 2019 as evidenced
by Professional Tax Receipt No.
________________________________issued in the City of Manila on 15
January 2019, a photocopy of which is attached as Annex “B”.

4. She is a member in good standing of the Integrated Bar of the

Philippines (IBP), as shown by the IBP certifications attached hereto
as Annex “C” and Annex “C-1”, and a lifetime member of the IBP
with Lifetime Membership No.________________________________
evidenced by her IBP ID, a photocopy of which is hereto attached as
Annex “D”

5. She possesses all the qualifications and none of the

disqualifications for the office of Notary Public.

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6. She has never been convicted of any crime involving moral
turpitude. This is evidenced by a Certification of the Bar Confidant
as well as the clearances issued by the Office of the City Prosecutor
of City of Manila and the Regional Trial Court of City of Manila,
which are respectively attached as Annexes “E”, “F” and “G”.

7. She is currently a member of the Manila 1 Chapter of the

Integrated Bar of the Philippines.

8. A separate sheet of paper, containing three (3) specimen of

petitioner’s official signature, three (3) true impression of her dry
seal, and her three (3) passport-sized photographs, is attached as
Annex “H”.

9. She was born on __________________ at

___________________________.

10. She undertakes to submit her monthly report/s.

11. Petitioner undertakes to inform the Executive Judge of the

Regional Trial Court of __________________________ within ten (10)
days of any change in the previously given office address.

12. Petitioner likewise attaches photographs Annexes “I” to “J” of

her office as well as the cabinet where she intends to put the copies
of documents she is to notarize.

13. Petitioner is fully cognizant of the duties and responsibilities of

a notary public, and hereby promises to abide by and follow all the
rules and guidelines that may hereinafter be promulgated by the
Supreme Court relative to notarial practice and procedure;

14. Petitioner binds herself to pay the filing fees, publication costs
and other expenses incident to the filing of this petition.

15. Petitioner has complied with the Mandatory Continuing Legal

Education requirement for lawyers and is now on the 5 th
Compliance (Annex “K”). She is scheduled to attend the upcoming
IBP Convention in Iloilo City for her 6 th MCLE Compliance.

PRAYER

WHEREFORE, it is respectfully prayed that an order be issued by

this Honorable Court appointing petitioner,
_____________________________________, as Notary Public for the year
2019, with commission to expire on December 2020.

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Other reliefs just and equitable under the premises are likewise
prayed for.

City of Manila, 06 February 2019.

ATTY.
Petitioner
PTR No. MLA /15 Jan 2019/Manila
IBP Lifetime Member No. _________________/ Manila I
Roll No. _________________
MCLE Compliance No.
____________________/_________________

VERIFICATION &
CERTIFICATION OF NON-FORUM SHOPPING

I, ______________________________, of legal age, Filipino, after having

been duly sworn to in accordance with law, do hereby depose and
state that:

1. I am the Petitioner in the above-entitled case;

2. I have caused the preparation of the foregoing Petition;

3. I have read the allegations stated herein and to the best

of our knowledge and belief, the same are all true and correct of our
own personal knowledge and based on authentic documents in our
possession;

4. I have not commenced any other action or proceeding

against them involving the same issue in any other court or
tribunal;

5. To the best of my knowledge, there is no such action

pending with the Supreme Court, Court of Appeals, or any other
tribunal or agency against the herein respondents for the same
cause;

6. If undersigned should learn hereafter that a similar

action is pending before the Supreme Court, Court of Appeals or
any other court or tribunal, we hereby undertake to report the fact
within five (5) days to the court or agency wherein the original
pleading and sworn certification had been filed.
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 IN WITNESS WHEREOF, I have hereunto affixed my
signatures, this ____ day of ________ 2019 at the City of Manila.

_____________________________
Petitioner

SUBSCRIBED AND SWORN to before me this

____________________ at _____________, affiant exhibiting to me her
IBP ID with Roll of Attorneys No. _________________________________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.

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