The Lawphil Project Arellano Law Fovndation

FORM 1-A-SCC VERIFICATION AND CERTIFICATE OF NON-FORUM SHOPPPING I._____________________________________________, of legal age, (Name) _____________________________ _______________________, and a resident (citizenship) (civil status) of _______________________________________________________________, after having been duly sworn to in accordance with law, hereby, depose and say: 1. That I am the ____________________in the above-entitled case and have caused this ___________________________________ to be prepared; that I read and understood its contents which are true and correct of my own personal knowledge and/or based on authentic records. That I have not commenced any action of proceeding involving the same issue in the Supreme Court, the Court of Appeals or any other tribunal or agency; that to the best of my knowledge, no such action or proceeding is pending in the Supreme Court, the Court of Appeals or any tribunal or agency, and that, if I should learn thereafter that a similar action or proceeding has been filed or is pending before these courts of tribunal or agency, I undertake to report that the fact to the Court within five (5) days therefrom.

2.

IN WITNESS WHEREFOR, I have hereunto set my hand this ____ day of __________________,20____.

Affiant SUBSCRIBED AND SWORN to before me this______day of _______________, 20_____ . NOTARY PUBLIC