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Petition Verification and Certification Form

This document is a verification and certification signed by an affiant. In it, the affiant states that they are the petitioner in the case, that they prepared and read the petition and that its contents are true and correct based on their personal knowledge. The affiant also certifies that they have not previously filed any claims involving the same issues in any court and will report if a similar claim is filed in the future. The document is signed and notarized.

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AnDrew Bautista Cayabyab
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115 views1 page

Petition Verification and Certification Form

This document is a verification and certification signed by an affiant. In it, the affiant states that they are the petitioner in the case, that they prepared and read the petition and that its contents are true and correct based on their personal knowledge. The affiant also certifies that they have not previously filed any claims involving the same issues in any court and will report if a similar claim is filed in the future. The document is signed and notarized.

Uploaded by

AnDrew Bautista Cayabyab
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

VERIFICATION AND CERTIFICATION

I, ____________________, of legal age, Filipino, single, with postal


address at ____________________, Philippines, after being duly sworn to in
accordance with law, freely depose and say:

THAT—

1. I am the PETITIONER in the above entitled case.

2. I caused the preparation of the foregoing PETITION.

3. I read and understood all the contents thereof and the same are true
and correct of my own personal knowledge or based on authentic
documents.

4. I certify that: (a) I have not theretofore 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
nor claim is pending thereto; (b) if there is such other pending action
or claim, I shall make a complete statement of the present status
thereof; and (c) if I should thereafter learn that the same or similar
action or claim has been filed or is pending, I shall report that fact
within five (5) days there-from to this Honorable Court.

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


day of April 2019 at ____________________, Philippines.

____________________
Affiant
ID No. ______________

SUBSCRIBED AND SWORN to before me this ____ day of April 2019 at


____________________, Philippines, affiant exhibited to me her positive
identification duly noted above below her name and signature, is known to me and
to me known to be the same person who executed the foregoing instrument and
acknowledged before me that the same is her free act and deed and that she
voluntarily executed the same and understood all the contents thereof.

WITNESS MY HAND AND SEAL.

Doc. No. _______;


Page No. _______;
Book No. ______;
Series of 2019.

Page 1 of 4

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