ACKNOWLEDGMENT

(Simple Form)

REPUBLIC OF THE PHILIPPINES )

CITY OF ____________________ ) S.S.

BEFORE ME, this ____ day of ____, 2___ in the City of _______, personally appeared:

Name Competent Evidence of Place and Date of Issue

Identity
________________________ ________________________ ________________________
__________________ __________________ ________________________

known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date
and place above written.

Doc. No. __________; NOTARY PUBLIC for __________

Page No. __________; Commission Serial No. _________
Book No. __________; Until December 31, ____________
Series of __________. Roll of Attorney _______________
IBP No. ____/Date/Place of Issue
PTR No. ____/Date/Place of Issue
 ACKNOWLEDGMENT OF INSTRUMENT CONSISTING OF TWO OR MORE PAGES

REPUBLIC OF THE PHILIPPINES )

CITY OF ____________________ ) S.S.

BEFORE ME, this ____ day of ____, 2___ in the City of _______, personally appeared:

Name Competent Evidence of Place and Date of Issue

Identity
________________________ ________________________ ________________________
__________________ __________________ ________________________

known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.

This instrument, consisting of _____ pages, including the page on which this acknowledgment is
written, has been signed on the left margin of each and every page thereof by _______________ and
_______________ and their witnesses, and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date
and place above written.

Doc. No. __________; NOTARY PUBLIC for __________

Page No. __________; Commission Serial No. _________
Book No. __________; Until December 31, ____________
Series of __________. Roll of Attorney _______________
IBP No. ____/Date/Place of Issue
PTR No. ____/Date/Place of Issue
 ACKNOWLEDGMENT BY CORPORATION

REPUBLIC OF THE PHILIPPINES )

CITY OF ____________________ ) S.S.

BEFORE ME, this ____ day of ____, 2___ in the City of _______, personally appeared:

Name Competent Evidence of Place and Date of Issue

Identity
________________________ ________________________ ________________________
__________________ __________________ ________________________

known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their free act and deed.

This instrument relates to the sale (or mortgage) of _____ parcels of land, and consists of ____ pages,
including the page on which this acknowledgment is written, has been signed on the left margin of each
and every page thereof by _______________ and _______________ and their witnesses, and sealed with
my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date
and place above written.

Doc. No. __________; NOTARY PUBLIC for __________

Page No. __________; Commission Serial No. _________
Book No. __________; Until December 31, ____________
Series of __________. Roll of Attorney _______________
IBP No. ____/Date/Place of Issue
PTR No. ____/Date/Place of Issue
 ACKNOWLEDGMENT BY OF INSTRUMENT CONVEYING TWO OR MORE PARCELS OF
LAND

REPUBLIC OF THE PHILIPPINES )

CITY OF ____________________ ) S.S.

BEFORE ME, this ____ day of ____, 2___ in the City of _______, personally appeared:

Name Competent Evidence of Place and Date of Issue

Identity
________________________ ________________________ ________________________
__________________ __________________ ________________________

representing to be the President (or manager) of ______________________________, and known to me

to be the same persons Who executed the foregoing instrument for and in behalf of the said corporation,
and he acknowledged to me that the same is the corporate act and deed of _______________, and that he
is duly authorized to sign the same.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date
and place above written.

Doc. No. __________; NOTARY PUBLIC for __________

Page No. __________; Commission Serial No. _________
Book No. __________; Until December 31, ____________
Series of __________. Roll of Attorney _______________
IBP No. ____/Date/Place of Issue
PTR No. ____/Date/Place of Issue
 JURAT

SUBSCRIBED and sworn to before me, this ___ day of ___________, in the City of
____________________ by ____________________ with Passport No. ___________ issued on
____________________ at ____________________.

Doc. No. __________; NOTARY PUBLIC for __________

Page No. __________; Commission Serial No. _________
Book No. __________; Until December 31, ____________
Series of __________. Roll of Attorney _______________
IBP No. ____/Date/Place of Issue
PTR No. ____/Date/Place of Issue
 VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING (OF
PLEADING)

VERIFICATION AND CERTIFICATION

REPUBLIC OF THE PHILIPPINES )

CITY OF ____________________ ) S.S.

I, ____________________, Filipino, of legal age residing at ____________________, after

being sworn to in accordance with law, deposes and says that:

1. I am the Plaintiff in the above-entitled case;

2. The facts stated in the above complaint are true and correct to the best of my knowledge and
authentic records;

3. I have not commenced any action or filed any claim involving the same issues in any court,
tribunal or quasi-judicial agency and, to the best of my knowledge, no such other action or claim
is pending in them; and

4. If I should learn that the same or similar action or claim has been filed or is pending after its
filing, I shall report that fact within five (5) days from notice to the court or where the complaint
or initiatory pleading has been filed.

(Date and venue)

Signature of Affiant

JURAT