VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, __________________________, of legal age, single/married, Filipino, and a

resident of _______________________________________, on oath, state that:

1. As the ____________ in the above-entitled case, have caused this

______________________ to be prepared; that I read and understood its
contents which are true and correct, based on personal knowledge and authentic
documents;
2. The pleading is not filed to harass, cause unnecessary delay, or needlessly
increase the cost of litigation;
3. The factual allegations stated have evidentiary support or if specifically so
identified, will likewise have evidentiary support after a reasonable opportunity for
discovery;
4. I have not commenced any action or proceeding involving the same issue before
the Supreme Court, the Court of Appeals or any other tribunal or agency; and
5. To the best of my knowledge, no such action or proceeding is pending in the
Supreme Court, the Court of Appeals or any other tribunal or agency, and that, if
I should learn thereafter that a similar action or proceeding has been filed or is
pending before these courts or tribunal or agency, I undertake to report that fact
to the Court within five (5) calendar days therefrom.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________ day of

_____________________, 2020.

_____________________________
Affiant
 SUBSCRIBED AND SWORN to before me this _________day of ______________,
2020 at ____________________________________.

NOTARY PUBLIC

Doc. No. __________;

Page No. __________;
Book No. __________;
Series of 2020.