Template For Appointment of Notarial Commission

REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT

7TH JUDICIAL REGION
Branch ____
___________ City
IN RE: PETITION FOR APPOINTMENT AS

CASE NO:________
NOTARY PUBLIC FOR THE CITY OF
_____________ AND THE
MUNICIPALITIES UNDER THE
JURISDICTION OF THIS HONORABLE
COURT
________________________________
(Name of Applicant)
Petitioner
x -------------------------------------------------------------------------/
PETITION
PETITIONER, _________________, unto this Honorable Court, most

respectfully alleges:
1. Petitioner is of ___ years old, for having been born on ____________.

He/She is a Filipino Citizen, married, has been a resident of
_______________, Philippines since his/her birth. She/He is with the
office address and regular place of business at
_________________Philippines with telephone numbers: (032)
_________________ and 09_________________ ; and in which
jurisdiction he/she now applies to be given a Notarial Commission. In
the event, however, that the Petitioner ceases to maintain the aforesaid
place of business, he/she hereby undertakes to notify this Honorable
Court within ten (10) days from such change of business address;
2. He/She has never been charged or convicted of any crime involving

moral turpitude, and herewith attached is a clearance from the Regional
Trial Court __________ City, as ANNEX “A” of this Petition; and
Clearance issued by the National Bureau of Investigation ( NBI) dated
__________ herein attached as ANNEX “A-1”
3. He/She is a member of the Philippine Bar with Roll Number ________,

as evidenced by Certificate of Membership in the Philippine Bar dated
__________, a copy of which is hereto attached as ANNEX “B” and
made and integral part of hereof;
1
4. He/She has paid his/her privilege taxes for the year 2016 as evidenced
by Professional Tax Receipt No. _____, dated __________, a copy of
which is attached hereto and made an integral part hereof as ANNEX
“C”;
5. He/She is a member of good standing of the Integrated Bar of the

Philippines, being a member thereof, as evidenced by a Clearance from
the Integrated Bar of the Philippines Cebu Chapter and for whom two
(2) executive officers of the Integrated Bar of the Philippines Cebu
Chapter issued a Joint Certification of his/her being a member of good
standing and of his/her good moral character, which Joint Certification
is attached as ANNEX “D” herewith; likewise, a Clearance from the
Office of the Bar Confidant, dated ___________ is attached herewith as
ANNEX “E”;
6. He/She has paid the required IBP Membership Dues for CY 2016, and
Building Fund contribution to the Integrated Bar of the Philippines as
evidenced by Official Receipt No. ___________, dated _____________,
a copy of which is attached hereto and made an integral part hereof as
ANNEX “F”;
7. Three (3) un-retouched passport size colored photographs of Petitioner,

taken within thirty (30) days before the filing of this Petition, with
his/her signature at the bottom thereon is attached herewith as ANNEX
“G”;
8. Facsimiles of petitioner’s signature appear on the sheet of paper attached

hereto and made an integral part hereof as ANNEX “H”;
9. That proper and adequate payment is made for the filing of this petition
as required by the rules. Official Receipt as proof of payment is included
in this petition as:
RTC O.R. No.__________, dated ___________, =P= ________;
RTC O.R. No.__________, dated ___________, =P= ________;
RTC O.R. No.__________, dated ___________, =P= ________;
10. Petitioner has not applied for commission in any other court of the
Philippines.
2
PRAYER
WHEREFORE, it is hereby respectfully prayed that Petitioner be granted an

appointment as Notary Public for and in the City of _____________ and in the
Municipalities of _____________ Philippines within the jurisdiction of this Honorable
Court, for year 2016 until December 31, 2017.
Also Petitioner prays that he/she be issued a certificate of authorization to

purchase a Notarial Seal.
Respectfully submitted.
Done this _____________ in _____________Cebu, Philippines.
Atty. _________________
Address
Roll No. _______
PTR No. ___________________
IBP No. ___________________
Exempt Pursuant to MCLE Governing Board No. 1
Series of 2008
Admitted June ________2016
Contact # ________________/ Email ______________
3
Republic of the Philippines)
City of ________________)S.s
VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING
I, ___________________, legal age, Filipino, single/married, and a resident of

______________ after having been sworn to an oath in accordance with the law, depose
and say;
That I am the Petitioner in the above- entitled proceedings that prepared the foregoing
petition;
That I have reviewed the Petition and the allegations therein are true and correct based
on my personal knowledge or based on authentic records.
Further, I certify that I have not filed any other petition for issuance of notarial
commission in any other court or tribunal in the Philippines.
IN WITNESS WHEREOF, I have hereunto affixed my signature this

________________ in ______________, Philippines.
_______________
Affiant
SUBSCRIBED AND SWORN to before me this ______________ in the City of

____________, Philippines, affiant exhibited to me his/her competent proof of identity
indicated as: _____________________.
Doc. ___
Page ___
Book ___
Series of 2016.

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REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

IN RE: PETITION FOR APPOINTMENT AS

PETITIONER, _________________, unto this Honorable Court, most

1. Petitioner is of ___ years old, for having been born on ____________.

2. He/She has never been charged or convicted of any crime involving

3. He/She is a member of the Philippine Bar with Roll Number ________,

5. He/She is a member of good standing of the Integrated Bar of the

7. Three (3) un-retouched passport size colored photographs of Petitioner,

8. Facsimiles of petitioner’s signature appear on the sheet of paper attached

RTC O.R. No.__________, dated ___________, =P= ________;

RTC O.R. No.__________, dated ___________, =P= ________;

RTC O.R. No.__________, dated ___________, =P= ________;

WHEREFORE, it is hereby respectfully prayed that Petitioner be granted an

Also Petitioner prays that he/she be issued a certificate of authorization to

Done this _____________ in _____________Cebu, Philippines.

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, ___________________, legal age, Filipino, single/married, and a resident of

IN WITNESS WHEREOF, I have hereunto affixed my signature this

SUBSCRIBED AND SWORN to before me this ______________ in the City of

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1. Petitioner is of _ years old, for having been born on __________.

RTC O.R. No.____, dated _, =P= ____;

RTC O.R. No.____, dated _, =P= ____;

RTC O.R. No.____, dated _, =P= ____;

Done this _ in _Cebu, Philippines.