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Republic of the Philippines )

City of Iloilo ) s.s.


x---------------------------------x

VERIFICATION and CERTIFICATION

I, _____________, single, of legal age, Filipino Citizen, and


resident of _______________________, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and say:

1. That I am the Attorney-in-Fact of the Plaintiffs in the above-


entitled case;

2. That I have caused the preparation of the foregoing document;

3. That I have read and understood the same and I affirm the truth
of the allegations thereof of my personal knowledge and these are
based on authentic records on hand;

4. That I also certify that 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 and that to the
best of my knowledge, no such action or proceeding is pending in
any of the aforementioned courts or agencies and that if I should
hereafter learn of such similar action or proceeding, I undertake
to report that fact within five (5) days therefrom to this
Honorable Office.

IN WITNESS WHEREOF, I have set my hand this


____________ at Iloilo City, Philippines.

_______________________
Affiant

SUBSCRIBED AND SWORN to before me this


__________________ at Iloilo City, Philippines by
_________________________ who showed me his competent
evidence of identity by exhibiting his LTO Professional Driver’s License
No. _________________, and acknowledged that this Verification &
Certification is his true and voluntary act and deed.

Doc. No._____;
Page No._____;
Book No._____;
Series of 2017.

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