(CERTIFICATION OF NON – FORUM SHOPPING) LEGAL FORMS

CERTIFICATION OF NON – FORUM SHOPPING

REPUBLIC OF THE PHILIPPINES )

CITY OF MANILA ) S.S.

1) I have not commenced any action or filed any claim involving the same issues in any court, tribunal, or
quasi – judicial agency;
2) No such other action or claim is pending with any court, tribunal, or quasi – judicial agency; and
3) If I should learn that the same or similar action or claim has been filed or is pending after its filing, I
shall report that fact within 5 days to the Honorable Court or where the complaint or initiatory pleading has been
filed.

5th of October, 2021, City of Manila.

(sgd.) Mr. X
AFFIANT

SUBSCRIBED AND SWORN TO BEFORE ME, this 5th day of October, 2021, in the City of Manila by
Mr. X with LTO LICENSE NO. 12344, ISSUED ON: May 25, 2019 in LTO City of Manila

(Sgd.) ATTY. JUAN DELA CRUZ

Notary Public for Manila
Appointment No. 123
Until December 31, 2021
Roll No. 123456; 5/20/05
IBP No. 13456/ January 1, 2019/ City of Manila
PTR No. 213456/ January 1, 2019/ City of Manila
MCLE NO. I – 0001223; 9/09/2019
MCLE NO. II – 0002345; 9/09/2019

DOC. NO. 34
PAGE NO. 23
BOOK NO. III
SERIES OF 2021

By: Caffeinated Wisdom

Page 1