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REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT
NATIONAL CAPITAL JUDICIAL REGION
OFFICE OF THE EXECUTIVE JUDGE
QUEZON CITY

IN RE: PETITION
FOR COMMISSION
AS NOTARY
PUBLIC IN
___________ AND
BE ALLOWED TO
USE HER MARRIED
NAME,
_______________
_ AS A NOTARY
PUBLIC

_________________,
Petitioner
x---------------------------------------------------------x

PETITION

PETITIONER, ________________, unto this Honorable

Court, most respectfully states that:

1. Petitioner is 35 years of age, born on November 06, 1987,

married, Filipino Citizen, and a resident of
____________________;

2. Petitioner married __________ on ______________.

Appended as Annex “A” is petitioner’s Certificate of Marriage;

3. She is a member of the Philippine Bar having been admitted to

the practice of law on May 17, 2022 with Roll No.
__________ as evidenced by a Certificate of Membership
issued by the Office of the Bar Confidant of the Supreme Court,
a copy herein attached as Annex “B”;

4. She is currently holding office at the ________________,

_________________, Quezon City and can be contacted
through Telephone Number with Mobile Phone No.
_______________ and through landline with Telephone No.
____________________;
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5. She was granted the Authority to Practice Legal Profession by

the NDA Head of Office, thus, desires to be commissioned as a
Notary Public for and in Quezon City and possesses all the
qualifications and none of the disqualifications for the said
office, the Original being attached as Annex “C”;

6. Petitioner also wishes to use her married name as a Notary

Public, and be registered as ___________________;

7. She has not been accused of any crime involving moral

turpitude before any court or tribunal in the Philippines as
evidenced by a Certificate of Good Moral Character issued by
the Integrated Bar of the Philippines, Baguio-Benguet Chapter,
an NBI Clearance from the National Bureau of Investigation, a
Certificate of No Pending Administrative Case from the Office
of the Bar Confidant of the Supreme Court, and an RTC
Clearance from the Regional Trial Court of Quezon City, an
MeTC Clearance from the Metropolitan Trial Court of Quezon
City, and a Prosecutor Clearance from the Office of the City
Prosecutor in Quezon City, the Original files are attached hereto
as Annexes “D”, “E”, “F”, “G”, “H” and “I”,
respectively;

8. She has paid her membership fee with the Integrated Bar of the
Philippines as per IBP Official Receipt No. ____________
dated March 30, 2023, the printed copy of the receipt is
attached as Annex “J”;

9. She has also paid her Professional Tax as evidenced by PTR No.
_________ dated April 25, 2023, the copy of the receipt is
attached as Annex “K”;

10. She has also attached herein as Annex “L”, three (3)
passport-sized photographs of the petitioner, signed by the
petitioner at the bottom part taken within thirty (30) days from
the application, and three (3) specimens of her signatures,
herein attached as Annex “M”; and

11. She paid the required fees for the filing of the foregoing petition
as evidenced by the Official Receipt issued for that purpose
hereto attached as Annex “N”.

PRAYER

WHEREFORE, petitioner respectfully prays that she be

commissioned as Notary Public for the Quezon City, Philippines.
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Respectfully submitted this ____th day of _____, 2023 at

Quezon City, Philippines.

____________________
Petitioner
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REPUBLIC OF THE PHILIPPINES)

QUEZON CITY) S.S.

VERIFICATION

I, _________________, of legal age, married, Filipino

Citizen, with office address at N_____________________,
Quezon City depose and state that:

1. I am the petitioner in the above-mentioned Petition;

2. I have caused the preparation of the foregoing petition;
3. I certify that I have read and understood the contents
thereof and verify that the facts stated therein are true and
correct based on my personal knowledge and authentic
records.

IN WITNESS WHEREOF, I have hereunto set my hand this

27 day of April 2023, in the Quezon City, Philippines
th

________________________
Tax Identification No. ____________
Issued On 2009/07/06

SUBSCRIBED AND SWORN to before me this ____th day of

April 2023, affiant personally appearing before me and exhibiting to
me her above-mentioned competent evidence of identity representing
to me that she is one and the same person who executed the
foregoing.

Doc. No. :_____;

Page No.: _____;
Book No.:_____;
Series of 2023.