REPUBLIC OF THE PHILIPPINES

10th Judicial Region

REGIONAL TRIAL COURT
Office of the Executive Judge
Ozamiz City

In Re: Application for Level 1 Certification, Application No. _______

JUAN D. CRUZ,
Applicant.

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APPLICATION FOR LAW STUDENT PRACTICE

CERTIFICATION LEVEL 1

I, JUAN D. CRUZ, of legal age and a resident of Purok

Makiangayon, Flores St., Barangay Dalit, Clarin, Misamis Occidental,
state unto this Honorable Court under oath that:

1. I am currently enrolled at the MISAMIS UNIVERSITY-

COLLEGE OF LAW at HT Feliciano St., Aguada, Ozamiz
City. Attached herein is the photocopy of my enrollment
assessment form marked as “Annex A”;

2. I also attached in this application here a copy of my School’s

Identification card with corresponding Student No. ________,
marked as “Annex B”;

3. I also attached in this application my original three specimen

signatures, marked as “Annex C”;

4. I have satisfactorily and successfully completed all my first year

courses. Attached herein is an original copy of Certification
issued by College of Law and hereto marked as “Annex D”;

5. I will enroll in the clinical legal education of Misamis University

College of Law Legal Aid Program for the first semester of the
academic year 2020-2021;

6. I am aware of and will abide by the limitations under Sections 4,

and the duties and obligations under Section 6-8 of Rule l 38-A
of the Rules of Court;

7. I have paid the necessary fees under Section 21(1) of Rule 141 of
the Rules of Court for the issuance of the Level 1 Certification.
1
 Attached herein is a copy of the official receipt as proof of
payment and hereto marked as “Annex E”;

WHEREFORE, it is respectfully prayed that this application be approved and

the Level 1 Certification be issued.

City of Ozamiz , October __, 2020.

JUAN D. CRUZ
Applicant-Petitioner

SUBSCRIBED AND SWORN to before me, this _____day of _________ by

_______________________________ who exhibited to me his Valid ID with
No. ______________ issued at ____________, Philippines on
________________.

Doc. No. _________;

Page No. _________;
Book No. ________;
Series of _________;