VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING I, _______, of legal age, Filipino, married and with residence and postal

address at __________________, after being sworn in accordance with law, hereby depose and state: 1. 2. I am the Petitioner in the above-captioned case; I have caused the preparation of the foregoing Petition which I have read and all the allegations therein are true and correct to my own knowledge and belief and based on the records in my possession; I hereby certify that I have not commenced any other action or proceeding involving the same issues in any other court, tribunal or quasi-judicial agency, and to the best of my knowledge, no such other action or claim is pending herein; and Should I hereafter learn that a similar action or proceeding has been filed or is pending before the Supreme Court, the Court of Appeals, or different divisions thereof, or any other tribunal or agency, I undertake to promptly inform this Honorable Court of that fact within five (5) days therefrom.

3.

4.

AFFIANT FURTHER SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto set my hand this ________________ at _____________________.

_________________________ Affiant SUBSCRIBED AND SWORN to before me this day of __________ at _______________, affiant exhibiting to me her ________________________ issued on _______________ at _________________. Doc. No. ______; Page No. ______; Book No. ______; Series of 2011.