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Republic of the Philippines

REGIONAL TRIAL COURT OF ZAMBOANGA DEL SUR


OFFICE OF THE EXECUTIVE JUDGE
Pagadian City

IN RE: PETITION FOR NOTARIAL


COMMISSION FOR AND
IN THE CITY OF PAGADIAN

Application #______________
Petitioner.
x--------------------------------------------------x

PETITION

The undersigned petitioner, _____________, unto this Honorable Court


respectfully states that:

1. She is a Filipino citizen, single, 25 years old and a resident of__________. A


Copy of her Certificate of Live Birth is attached hereto as Annex “A”;

2. She has satisfactorily completed her law studies at ________ in March of


_____;

3. She has passed the ______ Bar Examinations and was admitted to the
Philippine Bar on _________, with Roll of Attorneys No. _____. A copy of
her Certificate of Bar Membership is hereto attached as Annex “B” and made
an integral part of this petition;

4. The undersigned has not been charged nor convicted in the first instance of
any crime involving moral turpitude;

5. She desires to be commissioned as Notary Public for and in the City of


__________. She possesses all the qualifications and none of the
disqualifications for said office;

6. In compliance with the requirements of the Honorable Court for Notarial


Commission, attached hereto are the following annexes and made an integral
part of this petition:

a. Three specimen of her Official Signature, as Annex “C”;


b. 3 pcs. Passport-size pictures with signature at the bottom taken within 30
days before the filing of this petition, as Annex “D”, “D-1” and “D-2”;
c. Copy of PTR Receipt, as Annex “E”;
d. Copy of the proof of payment of the Integrated Bar of the Philippines dues,
as Annex “F”;
e. Copy of proof of payment of the filing fee for this Petition, as Annex “G”.
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WHEREFORE, Petitioner respectfully prays that the Honorable Court grant
the Petition for Commission as Notary Public and Petitioner be commissioned as a
Notary Public in the City of ________.

______ day of ________, 2017, ________ City.

____________________
Petitioner
(address)
(phone number)
(email address)
Attorneys Roll No. _________

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VERIFICATION and CERTIFICATION
AGAINST FORUM SHOPPING

I, ________________, under oath, depose and state that:

I am the petitioner in the above-entitled petition; that I have caused the


preparation of the foregoing Petition; that I have read and understood the contents
thereof; and that all the allegations therein are true and correct of my own personal
knowledge and based on authentic records.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____


day of _______ 2017 in _________ City, Philippines.

__________________________
Petitioner

JURAT

SUBSCRIBED AND SWORN to before me in the City of ___________, this


_______ day of ________________ 2017, issued on ___________ in the City of
___________.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of _____.

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