VERIFICATION WITH

CERTIFICATION OF NON-FORUM SHOPPING

I, ESTELLE AUDREY ROXAS ANG, of legal age, single,

Filipino and resident of B21 L15 Cerritos Heights, Camella Daang
Hari, Molino IV, Bacoor, Cavite, under oath, do hereby certify:

1. That I am the Petitioner in the Petition for Correction of

Entry in the Certificate of Live Birth of Esthel Audrey
Roxas Ang with Registry No. 89-4196;

2. That I have caused the preparation and filing of the

foregoing Petition;

3. That I have read the contents thereof and the same are
true and correct to the best of my own personal
knowledge;

4. That I have not commenced any other action or

proceeding involving the same issues in the Supreme
Court, Court of Appeals or any other tribunal or agency;

5. That if I should thereafter learn that a similar action or

proceeding has been filed or is pending before the
Supreme Court, Court of Appeals or any other tribunal
or agency, I undertake to promptly inform this agency
of the fact within five (5) days therefrom; and

6. That I have signed this Petition on this 29th day of

June 2018 in Las Piñas City.

ESTELLE AUDREY ROXAS ANG

SUBSCRIBED AND SWORN to before me this 29th day of June 2018

at Las Piñas City, with Affiant exhibiting to me her Professional Regulation
Commission ID No. 0592754 until June 6, 2021.

Notary Public

Doc. No_____
Page No_____
Book No_____
Series of 2018