Republic of the Philippines

National Capital Judicial Region

METROPOLITAN/REGIONAL TRIAL COURT
[Location of the Court]
[Branch #]

[NAME],
Plaintiff,
Civil Case No. 0000-000000
-versus- For: [CAUSE OF ACTION]

[NAME],
Defendant,

COMPLAINT

COMES NOW, the plaintiff together with the undersigned counsel to this
most Honorable Court, MOST RESPECTFULLY STATES THAT:

1.)

2.)

3.)

4.)

5.)

PRAYER

WHEREFORE, premises considered, it is most respectfully prayed from this

Honorable Court that judgment be rendered in the favor of the Plaintiff and that
after such judgment:

1.)
2.)

Such other reliefs and remedies complimentary to the abovementioned premises

are likewise prayed for.

[Place of filing], Philippines, [Date of filing]

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, [PARTY DETAILS], after being sworn according to law, hereby depose

and state that:

1.) I am a plaintiff in the above-stated case;

2.) I caused the preparation of the foregoing complaint;

3.) I have read the contents thereof and the facts stated therein are true and
correct of my personal knowledge and/or on the basis of copies of documents
and records in my possession;

4.) I have not commenced any other action or proceeding involving the same
issues in the Supreme Court, the Court of Appeals, or any other tribunal or
agency;

5.) To the best of my knowledge and belief, no such action or proceeding is

pending in the Supreme Court, the Court of Appeals, or any other tribunal or
agency;

6.) If I should thereafter learn that a similar action or proceeding has been
filed or is pending before the Supreme Court, the Court of Appeals, or any
other tribunal or agency, I undertake to report that fact within five (5) days
therefrom to this Honorable Court.

Complainant
In witness thereof, I, [ATTY NAME], counsel of the plaintiff, have hereunto set
my hand this [DATE] at [PLACE].