REPUBLIC OF THE PHILIPPINES)

CITY OF. TAGUIG )S.S.

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, MODESTO TICMAN, of legal age, Filipino, single, and a resident of Unit 123 Avida 9 th,
BGC, Taguig City, after having been duly sworn in accordance with law hereby depose and
state:

1. That I am the plaintiff in the foregoing case;

2. That I have caused the filing of this complaint;

3. That I have read the contents and the allegations therein are true and correct as to
my personal knowledge;

4. That I have not filed before a case involving the same issues before this court or any
other court, and that to the my best of knowledge no action involving the same
matter is pending in any other court;

5. That should I learn of any proceedings involving or action involving the same issues
in pending before a court, I shall notify within 5 days this honorable court and the
court where the case is pending.

Further affiant sayeth naught

IN WITNESS WHEREOF, I hereby affixed my signature this 30th day of January 2022 at
Taguig City.

MODESTO TICMAN
Affiant

JURAT

SUBSCRIBED AND SWORN to before me on this 31st day of January 2022 at Taguig City,
Philippines, affiant exhibiting his competent evidence of Identity by way of Philippine Postal ID
No. 1234, issued at Quezon City on January 1,2022.

Atty. Rex Central

Notary Public for Taguig City
Appointment No. 123
Until December 31, 2022
Roll No. 123
IBP No. 123
PTR No. 123/ Taguig City
MCLE Compliance No.1,
Doc. 1
Page 3
Book 5
Series of 2022