REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
FOURTH JUDICIAL REGION
PALLOCAN WEST, BATANGAS CITY
IN RE: APPLICATION FOR
NOTARIAL COMMISSION
P
PETITION NO. ____
APPLICANT
Petitioner.
x---------------------------------------------------------x
PETITION FOR NOTARIAL COMMISSION
COMES NOW, Petitioner ____________________________, unto
this Honorable Court, most respectfully states that:
1. Petitioner is of legal age, born on ______________, single, Filipino
citizen, and a resident of ____________________________;
2. Petitioner maintains a regular place of work at
____________________________, with contact number
____________________________;
3. Petitioner was admitted to the Philippine Bar on ______________ and
her signature was subscribed in the Roll of Attorneys No.
______________; Copy of her Certificate of Membership in the
Philippine Bar is hereto attached and made an integral part hereof as
Annex “A”;
4. Petitioner attaches hereto as Annex “B” a separate sheet of paper
showing her three (3) colored photographs;
5. Petitioner has paid her professional tax on ____________ at Batangas
City. Copy of her Professional Tax Receipt Number PTR No.
________ dated _____________ is hereto attached as Annex “C”;
6. Petitioner is a member in good standing of the Integrated Bar of the
Philippines, Batangas Chapter, and of good moral character. Copy of
the Certification dated ______________and signed by
______________, both executive officers of the IBP-Batangas
Chapter is attached as Annex “D”;
Petition for Notarial Commission
Page 1 of 5
7. Petitioner has no pending administrative or disbarment case filed
against her. Copy of the Certification issued by the IBP – National
Office dated ______________ is attached as Annex “E”;
8. Petitioner is a bona fide lifetime member of the Integrated Bar of the
Philippines, having paid the required dues and building fund
contribution to the Integrated Bar of the Philippines. A copy of the
Certification issued by the IBP – National Office dated
______________ is hereto attached as Annex “F”;
9. Petitioner has no pending administrative case filed against her before
the Office of the Bar Confidant, Supreme Court of the Philippines.
Copy of the Certification issued by the Office of the Bar Confidant
dated ______________ is attached as Annex “G”;
10. Petitioner has no pending criminal or civil case filed against her
before the Regional Trial Court, Fourth Judicial Region. Copy of the
Certificate of Clearance issued by the Office of the Clerk Court-
Regional Trial Court, Batangas City dated ______________ is
attached as Annex “H”;
11. Petitioner has never been charged nor convicted of any crime
involving moral turpitude. A copy of the clearance issued by the
National Bureau of Investigation dated ______________ is attached
as Annex “I”;
12. Petitioner attaches hereto as Annex “J” a separate sheet of paper
showing her official specimen signatures and true impression of her
notarial dry seal;
13. Petitioner desires to be commissioned as Notary Public for and within
the City of Batangas and Municipalities of San Pascual, Bauan,
Mabini, and Tingloy;
14. Petitioner possesses all the qualifications and none of the
disqualification for the said office;
15. The Tax Identification Number (TIN) of the Petitioner
______________;
16. Petitioner has paid the required filling fee with regard to this Petition
and attaches hereto as Annex “K” a separate sheet of paper showing
the official receipt with number ______________ dated
______________issued by the Office of the Clerk of Court – Regional
Trial Court, Batangas City;
17. Petitioner attaches hereto as Annex “L” the address of her office;
Petition for Notarial Commission
Page 2 of 5
PRAYER
WHEREFORE, PETITIONER respectfully prays that she be
appointed as Notary Public for and within the City of Batangas and
Municipalities of San Pascual, Bauan, Mabini, and Tingloy.
Other reliefs just and equitable under the premises are likewise prayed
for.
Batangas City, ______________
NAME OF APPLICANT
Roll of Attorneys No. ______________
PTR No. ______________ - January 1, 2018-
Batangas City IBP Lifetime No. ______________
MCLE Exempted, pursuant to MCLE
Governing Board Order No. 1, S.2008
Petition for Notarial Commission
Page 3 of 5
VERIFICATION AND
CERTIFICATION OF NON-FORUM SHOPPING
I, ______________, of legal age, single, Filipino citizen, and resident
of ______________, after having sworn to in accordance with law hereby
depose and state that;
1. I am the petitioner in the above-entitled petition for appointment as
notary public;
2. I have caused the preparation of the herein petition and the contents
thereof are true to the best of my knowledge;
3. I have not commenced any action or proceeding involving the same
issue in the Supreme Court, the Court of Appeals, or any other
tribunal;
4. To the best of my knowledge, no such action or proceeding is pending
in the Supreme Court, Court of Appeals, or different Divisions
thereof, or any other tribunal or agency;
5. If there is any other action or proceeding which is pending, or should I
thereafter learn that a similar action or proceeding has been field or is
pending before the Supreme Court, the Court of Appeals, or different
Divisions thereof, or any other tribunal or agency, I hereby undertake
to report that fact or the status thereof within five (5) days therefrom
to this Honorable Court.
IN WITNESS WHEREOF, I have hereunto signed my name this
_____________ at Batangas City, Philippines.
______________
Affiant
SUBSCRIBED AND SWORN to before me, this ___________ at
Batangas City by affiant exhibiting to me her driver’s license no.
________________.
Doc. No. _____;
Page No. _____;
Book No. _____; Petition for Notarial Commission
Page 4 of 5
Series of 2022.
Petition for Notarial Commission
Page 5 of 5
