VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, Juan Dela Cruz, of legal age and a resident of 20 San Miguel St., Quiapo, Manila,
under oath declare that:
1. I am the plaintiff in above-entitled case;
2. I have caused the preparation of this complaint; and
3. I have read it and its contents are true and correct of my personal knowledge and/or
based on authentic records; and
4. I have not earlier commenced a similar action against the defendant for the same cause
with any other court, tribunal or quasi-judicial agency and, to the best of my knowledge,
no such action or proceeding is pending with any other court, tribunal or quasi-judicial
agency; and If I should learn that a similar action or proceeding has been filed or is
pending before any other court, tribunal or quasi-judicial agency, I hereby undertake to
notify this Honorable Court within five (5) days from such notice.

(Sgd.) Juan Dela Cruz

JURAT