REPUBLIC OF THE PHILIPPINES )

CITY OF CEBU ) SS.

x -----------------------------------------------x

AFFIDAVIT OF FULL COMPLIANCE

I, ATTY. JUAN DELA CRUZ, of legal age, Filipino, single, and a resident of
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX, after
having been duly sworn in accordance with law, hereby depose and say:

1. That I am bona fide member of the Philippine Bar and have signed the Roll
of Attorneys on June XX, 20XX, with Roll of Attorneys No. XXXXX;

2. That I am a duly recognized member of the Integrated Bar of the Philippines

– Cebu Chapter;

3. That I am a “covered lawyer” under A.M. No. 17-03-09-SC;

4. That I have successfully rendered the required one hundred twenty (120)
hours of Community Legal Aid Services (CLAS), as provided for under A.M.
No. 17-03-09-SC;

5. That said compliance was rendered within twelve (12) months from the date
I signed the Roll of Attorney’s;

6. That I have not filed any petition for extension of my CLAS compliance with
the Office of the Bar Confidant (OBC);

7. That I am executing this affidavit to attest to the truth of the foregoing facts
and in accordance with the provisions of A.M. No. 17-03-09-SC.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of

_______________________ at Cebu City, Cebu, Philippines.

ATTY. JUAN DELA CRUZ

Affiant

Attested by:

ATTY. MICHAEL FRANCIS L. HUBAHIB

Chairperson – Committee on Legal Aid
Integrated Bar of the Philippines – Cebu Chapter

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SUBSCRIBED AND SWORN TO before me, a notary public in and for
__________________, this _____ day of __________________. The affiant, whom
I identified through the following competent evidence of identity:
________________________________________, personally signed the foregoing
instrument before me and avowed under penalty of law to the whole truth of the
contents of said instrument.

Doc. No. ____;

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

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