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VERIFICATION AND CERTICATION

OF NON-FORUM SHOPPING

I, _____________, of legal age, single, Filipino and with office address


at ___________ City, after having been duly sworn in accordance with
law, do hereby verify and certify under oath that:

1. I am the authorized representative of Petitioner ________in


this case and I have caused the preparation of the foregoing
Petition for Certiorari with Prayer for the Issuance of a
Temporary Restraining Order and/or a Writ of Preliminary
Injunction ;

2. I have read and understood the contents thereof and declare


the same to be true to the best of my knowledge;

3. I have not commenced any action or filed any claim involving


the same issues in any court, tribunal, or quasi-judicial agency
and to the best of my knowledge, no such other action or claim
is pending therein and that if I hereinafter learn that the same
or similar action or claim has been filed or is pending, I shall
report that fact within five (5) days therefrom to the Honorable
Court.

IN WITNESS WHEREOF, I have hereunto affixed my signature


this 5th day of September, 2019 in Quezon City.

_________
Affiant

SUBSCRIBED AND SWORN TO before me this 5th day of May,


2019, affiant exhibited to me her Driver’s License I.D. No. ________
as sufficient evidence of his identity.

Doc. No._____
Page No._____
Book No._____
Series of 2019.

Copy furnished:
REPUBLIC OF THE PHILIPPINES)
CITY OF Quezon ) S.S.
x-------------------------------------x

AFFIDAVIT OF SERVICE

I, ---------, of legal age, Filipino, with office address at _________________


after having been duly sworn to in accordance with law, depose and state:

1. That on September 6, 2019, I served a copy of the pleading/paper through


express courier and by registered mail in accordance with Sec. 10 of Rule 13 of
the Rules of Court:

Petition for Certiorari with Prayer for the Issuance of a Temporary


Restraining Order and/or a Writ of Preliminary Injunction

In CA-G.R. SP No. ________ entitled _______________ by depositing a copy in


the post office in a sealed envelope, plainly addressed to the respondent’s lawyer
at his office with postage fully paid, as evidenced by Registry Receipt No. _______
attached and with instructions to the post master to return the mail to sender after
ten (10) days if undelivered.

IN WITNESS WHEREOF, I have hereunto set my hand this 6th day of


September 2019 in Makati City, Metro Manila, Philippines.

_____________
Affiant
Drivers License No.___________

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