REPUBLIC OF THE PHILIPPINES

FOURTH JUDICIAL REGION

REGIONAL TRIAL COURT
City of XXXXX

IN RE: PETITION FOR APPOINTMENT AND

COMMISSION AS NOTARY PUBLIC for the CITY OF
XXXX, PROVINCE OF XXXXX

A.NC. No. _________________

Atty. XXXXXXXXX
Petitioner
X --------------------------------------X

PETITION

Petitioner, XXXXXXXX unto this Honorable Court, most respectfully files this petition
for appointment and commission as a Notary Public for the City of XXXX, Province of
XXXXX. In support of this Petition, she most respectfully states that:

1. She is a Filipino citizen, single, over twenty-one years of age, and a resident in
the Philippines since birth and with office address at XXXXXXXXXXXX;

2. She has satisfactorily completed her law studies at the XXXXXXXXXXXXX;

3. She is a member of the Philippine Bar, having admitted on May 11, 2022 as
evidenced by a photocopy of her Certificate of Membership attached hereto as
Annex “A” and made an integral part of this Petition;

4. She is a member of the Philippine Bar in good standing with Clearance from the
Integrated Bar of the Philippines and the Integrated Bar of the Philippines –
XXXX Chapter ; Clearance from Office of the Bar Confidant and Clearance from
the Regional Trial Court , attached as Annex “B”, Annex “C” , Annex “D” and
“Annex E”, respectively and made an integral part of this petition;
5. She has no pending case as evidenced by the clearance issued by National
Bureau of Investigation (NBI), copy of which is attached hereto as Annex “F”;

6. She has paid her membership dues for 2022 on May 16, 2022, as evidenced by
IBP Official Receipt No. XXXXX together with the Certification issued by
Integrated Bar of the Philippines, copies of which are hereto attached as Annex
“G” respectively, and made an integral part of this Petition;

7. She has paid her Professional Tax for the year 2022 and was issued
Professional Tax Receipt (PTR) No. XXXX dated May 19, 2022, copy of which is
attached as Annex “H” and made an integral part of this Petition;

8. She has never been convicted of any crime involving moral turpitude before any
court or tribunal in the Philippines nor charged in any administrative case in
connection with her profession;

9. She has never been applied nor been commissioned as Notary Public in any
other jurisdiction for the term applied for;

10. She will submit all her notarial books and documents and acknowledged
documents after the expiration of her notarial commission as provided by law;

11. She possesses all the qualifications and none of the disqualifications for the
office of Notary Public and have read, understood and is willing to abide with the
2004 Rules on Notarial Practice;

12. She is attaching as Annex “I”, a facsimile of her notarial seal prepared in
accordance with Sec 2. Of Rule VII of the 2004 Rules on Notarial Practice for
approval of this Honorable Court, together with three (3) specimens of her official
signature;

13. She also submitted three (3) passport sized colored photographs with light
background taken not more than 30 days prior to the filing of this petition;
 14. She undertakes to immediately and promptly inform this Honorable Court of any
change in her address or contact number and to submit or report to the Office of
the Clerk of Court copies of all deeds notarized by her.

PRAYER

WHEREFORE, premised considered, it is most respectfully prayed of this Honorable Court,

that Petitioner be appointed and commissioned as Notary Public for and in the City of
XXXXX.
City of XXXXXXXXXX, ______ June 2022.

ATTY. XXXXXXXXXXXXXXXXX
Petitioner
ADDRESS MO PO
Attorney’s Roll No. xxxxx
PTR No. xxxxx/ City of xxxxx
IBP No. xxxxx
Admitted to the Bar: XXXX
Email Address: XXXXXXX