REPUBLIC OF THE PHILIPPINES )

City of Batangas ) S.S

VERIFICATION AND CERTIFICATION
AGAINST NON-FORUM SHOPPING

I, JUAN DELA CRUZ, of legal age, Filipino, married and a resident of C. Tirona
St., Batangas City, on oath, depose and state:

1. That I am the Plaintiff in the above-entitled case;

2. That I have caused the preparation and filing of the foregoing Complaint
for Sum of Money, and I have read all the allegations therein which are
true and correct based on my personal knowledge and authentic
documents;

3. That I further certify that there is no pending action or proceeding

involving the same issues in the Supreme Court, Court of Appeals, or any
other tribunal or agency. If I should thereafter learn that the same or
similar action is pending, I shall undertake to inform the Honorable Court
of this fact within five (5) days therefrom.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 18 th day of

November 2022 in Batangas City.

JUAN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN TO before me this 18TH day of November 2022 in

the City of Batangas with Driver’s License No. N03-18-0123456, valid until 14 February
2023, and I hereby certify that I personally examined the affiant herein and that I am
fully satisfied that he voluntarily executed the foregoing Complaint and he understood
all the allegations therein.

Page No. 28;

Doc. No. 140;
Book No. 18;
Series of 2022.