VERIFICATION/CERTIFICATION AGAINST NO-FORUM SHOPPING

REPUBLIC OF THE PHILIPPINES )

________________________ ) s.s.
I,
____________,
of
legal
age,
Filipino,
and
a
resident
of
__________________, after having been duly sworn to in accordance with law do
hereby depose and say:
1. That I am the plaintiff in the above-entitled case.

2. that I have caused the preparation of the foregoing Complaint and

have read the allegations contained therein;
3. the allegations in the said complaint are true and correct of my own
knowledge and authentic records;

4. I hereby certify that I have not commenced any other action or

proceeding involving the same issues in the Supreme Court, Court
of Appeals or any other tribunal or agency;
5. that if I should thereafter learned that a similar action or
proceeding has been filed or is pending in the Supreme Court, Court
of Appeals or any other tribunal or agency, I hereby undertake to
report that fact within five (5) days therefrom to the court or
agency wherein the original pleading and sworn certification
contemplated herein have been filed;
6. I executed this verification/certification to attest to the truth of the
foregoing facts and to comply with the provisions of Adm. Circular No. 0494 of the Honorable Supreme Court.

IN WITNESS WHEREOF, I have hereunto set my hand this __________

at ________________, Philippines.

__________________
__________________

SUBSRCIBED AND SWORN to before me this _______________ at ___________, Philippines. Affiant presented to me his identification
indicated below his name as competent evidence of his identity.