REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

_____________ JUDICIAL REGION
_____________

IN RE: PETITION FOR COMMISSION

AS NOTARY PUBLIC
_____________________________

Petitioner,
X- - - - - - - - - - - - - - - - - - - - - - - - - -- - -X

PETITION

PETITIONER, ________________________, unto this Honorable Court, most

respectfully states that:
1. She/He is of legal age and a Filipino citizen;
2. She/He is presently residing at _________________________ and residing therein
since _________ and maintains a regular place of work in the City of __________;
3. She/He is holding her/his private law office at
______________________________________________________________;
4. She/He has satisfactorily completed the required course in law at
_________________ in _________ (date of graduation);
5. She/He has passed the _______ Bar Examinations and admitted to practice law in
the Philippines on _________________. Copy of the Certificate of Bar Membership is
herewith attached as Annex “A” and made an integral part of this petition;
6. She/He is a member of the Philippine Bar in good standing with Clearances from the
Office of the Bar Confidant of the Supreme Court and the Integrated Bar of the
Philippines. Copy of said clearances are herewith attached as Annex “B” and Annex “C”,
respectively and made an integral part of this petition;
7. The undersigned has not been charged nor convicted in the first instance of any crime
involving Moral Turpitude;
8. She/He desires to be commissioned as Notary Public for and in Municipality/City of
____________ and possesses all the qualifications and none of the disqualifications for said
office;
9. In compliance to the requirements of the Honorable Court for Notarial Commission,
attached hereto are the following annexes and made an integral part of this petition:
a. Three Specimen of his/her Official Signature as Annex “D”;
b. Picture of Desk, Sketch of Prospective Office and sketch of the location of the
office as Annex “E”, “E-1” and “E-2”;
c. 3 pcs. 2X2 ID picture as Annex “F”;
d. Copy of IBP Membership Payment Receipt as Annex “G”;
e. Copy of PTR Receipt as Annex “H”.

PRAYER

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

Honorable Court that:

1. The Petition for Commission as Notary Public filed by the undersigned be acted
favorably; and
2. Petitioner be commissioned as a Notary Public in the Municipality/City of
______________.

Date ____________, Municipality/ City of ____________.

 __________________________
Petitioner
Address ______________________
Contact No.___________________
E-Mail Address ________________
Roll No. ______
IBP No. ______ /Date and Place of Issue
PTR No. _____ /Date and Place of Issue
MCLE Certificate of Compliance No.
____

VERIFICATION and CERTIFICATION AGAINST FORUM SHOPPING

I, ___________________, under oath, depose and state that:

1. I am the petitioner in the above-entitled petition;

2. I have caused the preparation of the foregoing Petition;

3. The allegations therein are true and correct based on my personal knowledge and
authentic records;

4. To the best of my knowledge, there are no other pending petitions of the same
nature before any court, tribunal or quasi-judicial agency; and
 5. Should I thereafter learn of any similar case pending before any other court,
tribunal or quasi-judicial agency, I shall promptly notify this court within five (5)
days from discovery.

____________________________
(Name of the Petitioner)

JURAT

SUBSCRIBED AND SWORN to before me in the _________ on this day of _________

20___, affiant exhibiting before me her/his (Government-issued Identification Card No. )
issued on _________ in ___________.

NOTARY PUBLIC

Doc. No. ______;

Page No.______;
Book No.______;
Series of ______.