REPUBLIC OF THE PHILIPPINES

11th Judicial Region

REGIONAL TRIAL COURT
Branch ___
Digos City

RE: PETITION FOR COMMISSION AS

NOTARY PUBLIC FOR AND IN THE
PROVINCE OF DAVAO DELSUR

ATTY. ROXANNE ZAPATOS JURIAL

Petitioner,

X----------------------------------------------/

PETITION FOR NOTARIAL COMMISSION

COMES NOW petitioner, unto this Honorable Court, most respectfully avers:

1. That petitioner is of legal age, Filipino, single, resident of Aurora 3rd, Digos City, and
maintains a regular place of work at Jose Abad Santos St., Digos City;

2. That she is a member in good standing of the Philippine Bar, Integrated Bar of the
Philippines and the Local IBP Chapter where she belongs;

3. That she possesses all the qualifications and none of the disqualifications for the
Office of a Notary Public;

4. That she was never convicted of any crime involving moral turpitude;

5. That the following are the pertinent data in connection with this petition;

Date of Birth : July 18, 1990

Residence : Aurora 3rd St., Digos City
Telephone
Number : (082) 553 - 1234
Professional Tax
Receipt No. : 1234567
Issued on : January 5, 2016
Roll Number : 12345
IBP Membership
Number : 123456
6. That she is a person of good moral character as certified by two (2) executive
officers of the IBP, Local Chapter, copies of which are hereto attached to form part of this

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petition;

7. That attached hereto are clearances from the Office of the Bar Confidant of the
Supreme Court and the Integrated bar of the Philippines to form part of this petition;

8. That attached hereto is the receipt of the payment of the application fee as proof of
payment for the filing of this petition to form part of this petition; and

9. That attached hereto, in a separate sheet of paper but a part of this petition, are
three (3) specimens of petitioner’s official signature, true impression of her dry seal and
three (3) passport size colored photographs.

P R A Y E R

WHEREFORE, premises considered, it is most respectfully prayed of this Honorable

Court that petitioner be issued a commission as Notary Public for and in the Province of
Davao del Sur for the period starting January 1, 2017 to December 31, 2018.

Petitioner prays for other reliefs just and equitable under the premises.

Digos City, Philippines, December 19, 2016

ROXANNE ZAPATOS JURIAL

Petitioner

REPUBLIC OF THE PHILIPPINES

PROVINCE OF DAVAO DEL SUR:S.S
CITY OF DIGOS CITY )
X-------------------------------------------/

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 VERIFICATION AND CERTIFICATION

That I, ROXANNE ZAPATOS-JURIAL of legal age ,Filipino ,single and a resident of

Aurora 3rd St., Digos City, after having been duly sworn to in accordance with law, do hereby
depose and say;

That I am the Petitioner of the above-entitled case;

That I caused the preparation and filing of the same;

That I read and understood all the contents therein;

That they are all true and correct to the best of my knowledge and belief;

That I have not commenced any other action or proceeding involving the same
issued in the Supreme Court, the Court of Appeals or any tribunal or agency;

That to the best of my knowledge , no such action or proceeding is pending in the

Supreme Court, the Court of Appeals or any tribunal or agency;

That is I should thereafter learn that a similar action or proceeding has been filed
or is pending in the Supreme Court , the Court of Appeals or any tribunal or agency,
I undertake to report the fact within five (5) days therefrom to the Court or agency
wherein the original pleading and sworn certification herein have been filed.

IN WITNESS WHEREOF, I have hereunto set my hand this 19th day of December 2016
at Digos City, Philippines.

ROXANNE ZAPATOS JURIAL

Affiant

SUBSCRIBED AND SWORN TO before me this 19th day of December 2016 at Digos
City, Philippines.

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Doc. No. JOHN LLOYD CRUZ
Page No. Notary Public
Book No. Until December 31, 2017
Series of: TIN No. 098-765-543
IBP No. 098765
PTR No. 432109
MCLE Compliance No. 000009

INTEGRATED BAR OF THE PHILIPPINES

DAVAO DEL SUR CHAPTER
Digos City, Davao del Sur
Philippines

CLEARANCE &
CERTIFICATE OF GOOD MORAL CHARACTER

THIS IS TO CERTIFY that ATTY. ROXANNE ZAPATOS JURIAL is a private

practitioner for and in the Province of Davao del Sur.

This serves to certify that the above named lawyer is a member of the Integrated Bar of
the Philippines, Davao del Sur Chapter, she is a member in good standing and has paid her
IBP memberships due for the year 2016
under the Official Receipt No.123 dated December 1, 2016.

This clearance and certificate of good moral character is issued for whatever legal
purposes this may serve her best.

Done on this 19th day of December at Digos City, Davao del Sur, Philippines.

ATTY. JUAN DELA CRUZ

Treasurer

ATTY. GABRIELA SILANG

Secretary

REPUBLIC OF THE PHILIPPINES

PROVINCE OF DAVAO DEL SUR:S.S
CITY OF DIGOS CITY )
X-------------------------------------------/

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 AFFIDAVIT

That I, ROXANNE ZAPATOS JURIAL, of legal age, Filipino, single and a resident of
Aurora 3rd St., Digos City, after having been duly sworn to in accordance with law, do hereby
depose and say;

1. That I am the same ROXANNE ZAPATOS JURIAL who caused this execution of this
affidavit;

2. That I am a Practicing Lawyer by profession with office address as Jose Abad Santos St.,
Digos City;

3. That as of date,I am applying for my notarial commission for and in the Province of
Davao del Sur and is filing a petition thereof with the Regional Trial Court, Branch____,
Digos City;

4. That as a requisite to the above-stated petition, I am manifesting herein that I have never
been convicted of any crime involving moral turpitude;

5. That this affidavit was executed to attest to the truth of the foregoing facts and to support
my petition for the renewal of my commission for and in the Province of Davao del Sur.

IN WITNESS WHEREOF, I have hereunto set my hand this 19 th day of December 2016
at Digos City, Philippines.

ROXANNE ZAPATOS JURIAL

Affiant

SUBSCRIBED AND SWORN TO before me this 19th day of December 2016 at Digos City,
Philippines.

Doc. No. JOHN LLOYD CRUZ

Page No. Notary Public
Book No. Until December 31, 2017
Series of: TIN No. 098-765-543
IBP No. 098765
PTR No. 432109
MCLE Compliance No. 000009

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