Republic of the Philippines }

Province of La Union } s.s

Municipality of Naguilian }

VERIFICATION/CERTIFICATION
OF NON-FORUM SHOPPING

I, KATHY BAYAN, of legal age, single, Filipino citizen and a resident of Barangay
oRTIZ, Naguilian, La Union, after having sworn to an oath in accordance with law, hereby
depose and state that:

1. I am the Complainant in the above-entitled petition;

2. I caused the preparation of the foregoing petition, read the contents thereof
and found the same to be true and correct of my own personal knowledge and or based
on authentic records;

3. I further certify;

a. I have not commenced or filed any other action or proceeding involving

the same issues in the Supreme Court, the Court of Appeals or any other
tribunal or agency;

b. That to the best of my knowledge and belief, no such action or

proceeding is pending before the Supreme Court, the Court of Appeals or
any other tribunal or agency;

c. Should I learn thereafter of any similar action pending before the

Supreme Court, Court of Appeals, or any other tribunal or Agency, I
undertake to report the fact within five (5) days to this Honorable Court;

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of March,
2020 at __________, La Union, Philippines.

CATALINA F. FUSILERO
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this ____ day of March, 2020 in

Naguilian, La Union, Philippines, after Affiant exhibited to me her Senior Citizen
identification card number xxxx who is known to me and to me known to be the same
person who signed before me the foregoing verification/certification and acknowledge
to me that he executed the same freely and voluntarily.