VERIFICATION AND CERTIFICATION

REPUBLIC OF THE PHILIPPINES )

CITY OF TAGBILARAN ) S.S.

I, _____________ Filipinos, of legal age, and a resident of Buenasue,

Bohol, Philippines after having been sworn to in accordance with law,
hereby, depose and say:

1. That I have caused the preparation and filing of the above complaint.
2. That I have read and understood the contents thereof and that the
allegations therein are true and correct of our own personal knowledge
and/or based on authentic records;
3. That I have not commenced any other action or proceeding involving
the same issues in the Supreme Court, the Court of Appeals, or any
tribunal or agency; that to the best of our knowledge no such action or
proceeding is pending in any court, tribunal or agency; and that if we
should thereafter learn that a similar action or proceeding has been
filed or is pending before the Supreme Court, the Court of Appeals or
any tribunal or agency, we undertake to inform this Honourable Court
within five (5) days therefrom.

IN WITNESS WHEREOF, I have set my hand this

_________________ at Tagbilaran City, Bohol, Philippines.

_________________
Affiant

SUBSCRIBED AND SWORN to before me this _________________

in the City of Tagbilaran, Philippines by the affiant with his competent
evidence of identity indicated below his name and signature.