REPUBLIC OF THE PHILIPPINES

9th JUDICIAL REGION

REGIONAL TRIAL COURT
Branch
Dipolog City

RE: PETITION FOR APPOINTMENT

AS NOTARY PUBLIC FOR AND IN
THE PROVINCE OF ZAMBOANGA
DEL NORTE

Petitioner,
ATTY. RODAN M. CUESTA Application No. XXXX

x-------------------------------------------------------------/

COMPLIANCE

The undersigned Petitioner, Atty. Rodan M. Cuesta, by way of

compliance with this Honorable Court’s Certificate of Authorization to
Purchase a Notarial Seal dated (Date; xx/ xx /xx) (the “Certificate”),
respectfully state that:

1. On (Date: xx/xx/xx), Petitioner was appointed by the Honorable

Executive Judge as a Notary Public for and in the City of Dapitan, for
the term beginning on the (Date: xx/xx/xx) and ending on the (Date:
xx/xx/xx). A copy of the Certificate is attached hereto as Annex “A”.

2. On the same date, by virtue of the Appointment, Petitioner was

authorized by the Honorable Court to purchase a Notarial Seal. A copy
of the Certificate is attached hereto as Annex “B”.

3. Pursuant to the Certificate, Petitioner purchased a Notarial Seal.

An impression of the same is attached hereto as Annex “C” and is being
presented to this Honorable Court for approval.

PRAYER

WHEREFORE, it is respectfully prayed that this Honorable Court

approve the undersigned’s Notarial Seal.

Other just and equitable reliefs are also prayed for.

(Date: xx/xx/xx), Dapitan City, Philippines.

Compliance
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