VERIFICATION AND CERTIFICATION

OF NON-FORUM SHOPPING

I, ANGELINA G. CURIBANG, Filipino citizen, of legal age,

and resident of Barangay Binguang, San Pablo, 3329 Isabela,
after having been duly sworn to in accordance with law, do
hereby depose and state that:

1. I am the petitioner in the above-entitled case.

2. I have caused the preparation of the foregoing

Complaint.

3. I have read and understood the same and all the

statements therein are true, correct, and of my own personal
knowledge, and/or based on authentic documents.

4. The factual allegations in the foregoing pleading

have evidentiary support and/or have evidentiary support
after a reasonable opportunity for discovery. The signature of
the herein affiants shall further serve as a certification of the
truthfulness of the allegations in the pleading.

5. The foregoing pleading is not filed to harass, cause

unnecessary delay, or needlessly increase the cost of litigation.

6. I hereby certify that (a) I have not commenced any

other action or proceeding involving the same issues thereto
with this Honorable Court, the Supreme Court, or any other
tribunal or agency; (b) to the best of our knowledge, no such
action or proceeding involving the same issues is pending
before this Honorable Court, the Supreme Court, or any
tribunal or agency; (c) if there is any action or proceeding
involving the same issues which is pending before this
Honorable Court, the Supreme Court or any tribunal or
agency, I will state the status thereof; and (d) should I learn
thereafter that a similar action or proceeding involving the
same issues is pending before this Honorable Court, the
Supreme Court, or any other tribunal or agency, we will report
that fact within five (5) calendar days therefrom to this
Honorable Court, and to the court where the original pleading
has been filed.
 IN WITNESS WHEREOF, we have hereunto affixed our
signatures this _____________________ at the Public Attorney’s
Office – Cabagan District Office, Cabagan, Isabela, Philippines.

ANGELINA G. CURIBANG
Identification Card Presented:

Valid Until:

SUBSCRIBED AND SWORN to before me this

__________________ at thePublic Attorney’s Office – Cabagan
District Office, Cabagan, Isabela, Philippines, affiant exhibiting
to me her aforementioned identification card, bearing her
respective name, picture and signature.