REPUBLIC OF THE PHILIPPINES

First Judicial Region

REGIONAL TRIAL COURT

Office of the Executive Judge

Baguio City

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

Ogie Rose L. Banasan

Applicant.

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APPLICATION

I, OGIE ROSE L. BANASAN, of legal age and a resident of Rimando St., Aurora Hill, Baguio City, state under oath that:
1. I am currently enrolled at the University of the Cordilleras, College of Law at Gov. Pack Road, Baguio City;
2. I have satisfactorily and successfully completed all my first year courses;
3. I will enroll in the school’s clinical legal education program for the first semester of academic year 2022-2023;
4. I am aware of and will abide by the limitations under Section 4, and the duties and obligations under Sections 6-8 of Rule 138-A of the Rules

of Court;
5. 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. Attached

herein is a copy of the official receipt as proof of payment;

WHEREFORE, it is respectfully prayed that this application be approved and the Level 1 Certification be issued.

City of Baguio, August ____, 2022.

OGIE ROSE L. BANASAN

Applicant

I.D. No.: 19-6110-134

Date of Issue: August, 2022

Place of Issue: Baguio City

SUBSCRIBED AND SWORN to before me this _______ day of August, in the City of Baguio, Philippines, by the above-named Affiant who is identified

by me through competent evidence of her identity. I further certify that the foregoing document was signed in my presence and that I have

personally examined the Affiant and I am convinced that she understood her statements as her free act and voluntary deed.
Doc. No.: _____;

Page No.: _____;

Book No.: _____;

Series of 2022.