I.

COMMON FORMS
A. Caption and Title

Republic of the Philippines

National Capital Judicial Region
REGIONAL TRIAL COURT
Branch 1, Manila

____________________,
Plaintiff,

-versus- Civil Case No._______________

For _______________________

______________________,
Defendant.
x------------------x

B. Prayer

PRAYER

WHEREFORE it is respectfully prayed, after notice and hearing, that the defendant be ordered to
pay the plaintiff the amount of One Million Pesos (Php.1,000,000) for actual and compensatory damages,
Fifty Thousand Pesos (Php.50,000) for moral damages, Fifty Thousand Pesos (Php.50,000) for exemplary
damages, and Fifty Thousand Pesos (Php.50,000) for attorney’s fees.

Other just and equitable reliefs are also prayed for.

C. Jurat

SUBSCRIBED AND SWORN TO before me in the City of _______________ on this day of

_________________, affiant exhibiting before me his Government Issued ID no. _______________
issued on __________________ at _____________________.

(Sgd.) N. O. TARIO
Notary Public
Until __________________
PTR No. _______________
Issued at ______________
On ___________________

Doc. No.
Page No.
Book No.
Series of 2007.