Republic of the Philippines

REGIONAL TRIAL COURT

_______ Judicial Region
_________ City

In Re: PETITION FOR RENEWAL OF PETITION FOR

COMMISSION AS NOTARY PUBLIC NOTARIAL
IN THE CITY OF ________________ COMMISSION
AND IN THE PROVINCE OF NO._________
____________________

_____________________________________,
Petitioner.
x---------------------------------x

PETITION

COMES NOW, the undersigned Petitioner, of legal age, married to

___________________________, resident of
__________________________, unto this Honorable Court, most
respectfully avers:

1. That she is a citizen of the Philippines, currently residing at

____________________________, and with landline telephone number
__________________ or mobile cellular phone number
_____________________where she may be reached;

2. That she is over twenty-one (21) years of age, having been born on
the ________________ in _________________, Philippines;

3. That she satisfactorily completed the required course of law in the

________________________________ in ___________________, passed
the _________ Bar Examinations and was admitted to the Philippine Bar on
_________________ with Attorney’s Roll Number ___________________;

4. That she is currently employed as _________________ of the

___________________________ at _____________________________
situated in the Province where she desires to be re-commissioned as a
Notary Public under the 2004 Rules of Notarial Practice;

5. That she possesses all the qualifications and none of the

disqualifications for said office and hereby submits the following documents
to support herein petition and forming an integral part thereof:
 a. Annex “A” : Certificate of Membership in the Philippine Bar,
issued on _______________ by Maria Christina B. Layusa, Deputy
Clerk of Court and Bar Confidant, Supreme Court of the Philippines;

b. Annex “B” : Certification that she is a member of the Philippine

Bar in good standing as cleared and certified by the Office of the
Bar Confidant that she has no pending administrative case against
her, issued on _______________ by Maria Christina B. Layusa,
Deputy Clerk of Court and Bar Confidant, Supreme Court of the
Philippines;

c. Annex “C” : IBP Official Receipt No. _____________ issued on

________________, and Professional Tax Receipt No.
____________ issued on _______________;

d. Annex “D” and “D-1”: Certification that she has paid the required
Membership Dues up to CY _________ and the Building Fund, and
that she is an IBP Member in good standing as cleared and certified
by the National Office of the Integrated Bar of the Philippines.

e. Annex “E” and “E-1” : Certification by two (2) executive officers

of the Integrated Bar of the Philippines, ___________________
Chapter that she is a member of good standing and that they have
no objection to her appointment as Notary Public for the City of
_______________ and in the Province of ____________________;

f. Annex “F” : Impressions of her current Notarial Seal with her

official signature and three (3) passport size color photographs with
light background taken within ten (10) days from filing of the
petition and Petitioner’s signature at the bottom thereof;

g. Annex “G” and “G-1” : Certification of MCLE Compliance

issued by the Supreme Court of the Philippines, MCLE Office on
______________, with MCLE Compliance No.
_________________, valid until _____________, and NBI
Clearance issued on ________________;

h. Annex “H” : Certification / Letter of Authority to practice legal

profession and to be commissioned as Notary Public for the
Province of ________________ and the City of _______________;

i. Official Receipts of the filing fees for the instant petition as required
by the Rules, herein attached;

6. That for the purpose of this petition, she hereby declares that she
has not filed a similar petition in any other court, nor has been commissioned
as Notary Public in any jurisdiction other than where the instant petition is
filed.
 WHEREFORE, in view of the foregoing, it is most respectfully prayed of
this Honorable Court that the undersigned Petitioner be granted Commission
as Notary Public for and in the City of ___________________ and in the
Province of _____________________.

________________ City, Philippines. ________________, 20___.

_____________________________
Petitioner

REPUBLIC OF THE PHILIPPINES )

Province of ________________ ) S.S.
City of ____________________ )
x-------------------------- x

I, _____________________, by these presents hereby depose and say:

a. That I have caused the above Petition to be prepared;

b. That I have read the contents thereof and know the allegations therein to be
true and correct of my own knowledge and based on authentic record.

_________________ City, Philippines. _______________, 20____.

___________________________________
Petitioner

JURAT
SUBSCRIBED AND SWORN TO BEFORE ME, this ____________________ at
________________ City, Philippines. Petitioner exhibited to me her ______________
identification card as competent evidence of identity.

Doc. No. ______;

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