Sie sind auf Seite 1von 2

VERIFICATION and CERTIFICATION

of NON-FORUM SHOPPING

I, NERISSA DEL FIERRO JUAN, of legal age, Filipino,


with residence address at Block 59 Lot 60 La Naval St., Lagro
Subdivision, Novaliches, Quezon City, after having been duly
sworn in accordance with law, hereby depose and state:

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

2. I have caused the preparation of the foregoing


Petition;

3. I have read and understood the contents and


allegations therein and they are true and correct of my own
personal knowledge, and/or based on authentic and relevant
documents and records;

4. I hereby certify that I have not commenced any other


action or filed any claim involving the same issues raised in
this Petition in the Supreme Court, Court of Appeals or
different divisions thereof, or in any other court, tribunal or
quasi-judicial agency and, to the best of my knowledge, no
such other action or claim is pending therein; and

5. Should I hereafter learn that another or similar action


or claim has been filed or is pending before the Supreme
Court, Court of Appeals or different divisions thereof, or in
any other court, tribunal or quasi-judicial agency, I shall
report that fact to this Honorable Court within five (5) days
from notice thereof.

IN WITNESS WHEREOF, I have hereunto set my hand


this ______ day of June, 2017 at Makati City.

NERISSA D. JUAN
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of


June 2017 at Makati City, affiant exhibiting to me her
___________________ with ____________________________ issued
by the ______________________ on ________________________.
Doc No.: ______;
Page No.:______;
Book No.:______;
Series of 2017.