VERIFICATION AND CERTIFICATION

(Pursuant to the Rules of Court and A.M. No. 15-04-06-SC)

_________________________, a corporation duly organized and existing under and by

virtue of the laws of the Republic of the Philippines, with principal office at
_______________________ (hereinafter, the “Corporation”), by and through its duly
authorized representative, the Corporation’s President, ______________, after having
been duly sworn in accordance with law, do hereby depose and state THAT:

1. I am the duly authorized representative of the Petitioner Corporation;

2. I caused the preparation and the filing thereof;
3. I have read the contents thereof;
4. I have read the submission and its factual allegations are true and correct of my
personal knowledge or based on authentic records;
5. The facts stated therein are true and correct of my personal knowledge and/or on
the basis of authentic copies of documents and records in my possession;
6. The pleading is not filed to harass, cause unnecessary delay, or needlessly increase
the cost of the litigation;
7. This petition to which this verification and certification is attached contains
supporting annexes, which I attest as faithful reproduction of the originals
(original copies are also attached herewith);
8. The factual allegations therein have evidentiary support or, if specifically so
identified, will likewise have evidentiary support after a reasonable opportunity for
discovery;
9. I have not theretofore 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 therein;
10. There is no such other pending action or claim; had there been, a complete
statement of the present status thereof would have been included in this Petition;
11. If I should thereafter learn that the same or similar action or claim has been filed
or is pending, I shall report that fact within five (5) calendar days therefrom to the
court wherein my aforesaid complaint or initiatory pleading has been filed.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

___________________, at _________.

___________________________________

By:

________________

REPUBLIC OF THE PHILIPPINES )

PASIG CITY ) S.S.

Subscribed and sworn to before me this ________________, by affiant

________________having exhibited his competent ID, ________________issued
________________, at ________________.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of _____