Republic of the Philippines

REGIONAL TRIAL COURT

OFFICE OF THE EXECUTIVE JUDGE
Fifth Judicial Region
Province of Sorsogon

IN THE MATTER OF THE PETITION SP. PRO. NO. _____________

FOR RENEWAL OF COMMISSION
AS NOTARY PUBLIC IN AND FOR
THE PROVINCE OF SORSOGON;

______________________________,
Petitioner.
x-------------------------------------------------------x

PETITION FOR RENEWAL OF

COMMISSION AS NOTARY PUBLIC

PETITIONER, to this Honorable Court, respectfully states that:

1. He is ____ years of age, born on _____________, married, Filipino Citizen,

with office address at _____________________________;

2. He has been admitted to the practice of law in the Philippines on

___________________, with Roll of Attorney No. __________;

3. He is applying for renewal of notarial commission under Section 13, Rule III of
the 2004 Rules on Notarial Practice and pursuant to OCA Circular No. 110-
2014 is attaching hereto clearances from the following:

a) Office of the Bar Confidant;

b) Local Chapter of the Integrated Bar of the Philippines; and
c) National Bureau of Investigation.

4. He has all the qualifications and none of the disqualifications for the Office of
Notary Public;

5. He has never been charged nor convicted of any crime involving moral
turpitude;

6. He has no commission as notary public in any other jurisdiction.

PRAYER

WHEREFORE, premises considered, Petitioner respectfully prays of this

Honorable Court that he be granted a Notarial Commission, in and for the City and the
Province of Sorsogon, for the year __________, ending on December
___________________.

December 15, 2020 at Sorsogon City.

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 _____________________________________
PETITIONER
DESTURA LAW OFFICE AND NOTARIAL SERVICES
3120 Galarosa St., Talisay, Sorsogon City
Roll No. 68914
IBP No. 100285-January 2, 2020
PTR No. 2523195- January 2, 2020
MCLE Compliance VI, Sept. 15, 2018

VERIFICATION AND CERTIFICATION

 

REPUBLIC OF THE PHILIPPINES)

Province of Sorsogon ) S.S.
City of Sorsogon )
 

    I, _____________________________, after being sworn in accordance with law,

hereby depose and say:
 
     That I am the Petitioner in the above-entitled case; That I have caused the
preparation of the above Petition and I have read the same and know the contents thereof;
That the allegations contained therein are true and correct of my own personal
knowledge.

   That I further certify that: (a) I have not theretofore  commenced any other action
or proceeding or filed any claim involving the same issues or matter in any court,
tribunal, or quasi-judicial agency and, to the best of my knowledge, no such action or
proceeding is pending therein; (c) if I should thereafter learn that the same or similar
action or proceeding has been filed or is pending before the Supreme Court, the Court of
Appeals, or any other tribunal or quasi-judicial agency, I undertake to report such fact
within five (5) days there from to the court or agency wherein the original pleading and
sworn certification contemplated herein have been filed.
 

IN WITNESS WHEREOF, I have hereunto set my hands this _____________,

at Sorsogon City, Sorsogon, Philippines.
 

_________________________________
AFFIANT

    SUBSCRIBED AND SWORN to before me in the City of Sorsogon, this

_________________, by __________________________ known to me to be the same
person who personally signed before me the foregoing Petition and acknowledged to me that
he executed the same.

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Doc. No.:_________;
Page No.:_________;
Book No.:_________;
Series of 20___.

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