REPUBLIC OF THE PHILIPPINES)

CITY OF ___________________________) S.S

VERIFICATION WITH CERTIFICATION

OF NON-FORUM SHOPPING

I, _______________________, of legal age, Filipino, after having been sworn

to in accordance with law hereby depose and state that:

1. I am the COMPLAINANT/APPELLANT in the case entitled “++++++ al.”

docketed as NLRC LAC No. ____________;

2. I have caused the preparation of the foregoing Motion for Reconsideration

and I have read the contents thereof, which are true and correct of my own
personal knowledge and/or based on authentic records;

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

4. If I should thereafter learn that the same or similar action or claim has been
filed or is pending, I undertake to inform this Honorable Court within five
(5) days from notice thereof.

IN WITNESS WHEREOF, I hereby set my hand in writing this ____ day of

February 2020 here in the City of _________________.

_____________________
Affiant

SUBSCRIBED AND SWORN to before me this ___ day of February 2020

here in the City of _____________, affiant exhibiting to me her ________________
bearing No. _________________ as competent proof of her identity.

Doc. No. ______

Page No. ______
Book No. ______
Series of 2020.