VERIFICATION

I, _______________________________________, Filipino, of legal age, and

residing at ____________________________________________________________,
after having been duly sworn in accordance with law, do hereby depose and
state that:

1. I am the _______________ in the instant case and have caused the preparation
of the ________________________________, which I have read and
understood, and the allegations and contents of which are all true and correct
of my own personal knowledge and/or based on authentic records;

2. The aforementioned _______________ is not intended to harass, cause

unnecessary delay, or needlessly increase the cost of litigation; and,

3. The factual allegations in the aforementioned ______________ have

evidentiary support.

AFFIANT FURTHER SAYETH NAUGHT.

______________________________________
Affiant

SUBSCRIBED AND SWORN TO before me this _______________ at the

City of __________________, affiant personally exhibiting to me
___________________________.

Doc No.
Page No.
Book No.
Series of 2021.