VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, CARDI BEE, of legal age, after having been duly sworn in accordance with law,
depose and state that:

1. I am a complainant in the above-stated case;

2. I caused the preparation of the foregoing complaint;
3. I have read the contents thereof and the facts stated therein are true and correct of
my personal knowledge and/or on the basis of copies of documents and records in my
possession;
4. I have not commenced any other action or proceeding involving the same issues in
the Supreme Court, the Court of Appeals, or any other tribunal or agency;
5. To the best of my knowledge and belief, no such action or proceeding is pending in
the Supreme Court, the Court of Appeals, or any other tribunal or agency;
6. If I should thereafter learn that a similar action or proceeding has been filed or is
pending before the Supreme Court, the Court of Appeals, or any other tribunal or
agency, I undertake to report that fact within five (5) days therefrom to this Honorable
Court.

CARDI BEE
Affiant

SUBSCRIBED AND SWORN to before me this 25th day of February,

2018 at Bacolod City, affiant exhibiting to me his Community Tax Certificate No.
13131413 issued on January 1, 2018 at Bacolod City.

NOTARY PUBLIC

Doc. No. 122;

Page No. 12;
Book No. 12;
Series of 2018.
 JURAT

SUBSCRIBED AND SWORN to before me, this JUNE 20, 2018, by Cardo Dalisay
who exhibited to me his Community Tax Certificate No. 123456 issued at Makati
City, Philippines on January 1, 2018.

Notary Public

Doc. No. 123;

Page No. 12;
Book No. 12;
Series of 2018.
REPUBLIC OF THE PHILIPPINES)


CITY OF MAKATI) SS.

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the City of Makati, personally appeared
Cardo Dalisay with Community Tax Certificate No. 123456 issued on January 1,
2018 at Makati City, and Cardi Bee with Community Tax Certificate No. 654321
issued on January 2018 at Makati City, both known to me and to me known to be the
same persons who executed the foregoing instrument which they acknowledged to me
to be their free and voluntary act and deed, consisting of only three (3) pages,
including this page in which this Acknowledgement is written, duly signed by them
and their instrumental witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL this _____________ at _____________,

Philippines.

NOTARY PUBLIC

Doc. No. 124;

Page No. 12;
Book No. 12;
Series of 2018.

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 02
Tuguegarao City, Cagayan

CARDI BEE
Complainant CASE NO. ______________________

- Versus -

CARDO DALISAY
Respondent/s

QUITCLAIM AND RELEASE

COMES NOW the undersigned complainant in the above entitled case before
this Office, respectfully manifest:
 That for in consideration of the sum of One Hundred Thousand Pesos
(P 100, 000) in settlement of my claim; as financial assistance given by my employer,
receipt of which is hereby acknowledge to my complete and full satisfaction. I hereby
release and discharge the employer and / or its officer, from any and all by way of
unpaid wages, separation pay, overtime pay, differential pay or otherwise as may be
due me/us incident to my/our past employment with said establishment. I/We hereby
state further that I have no more claim or cause of action of whatever nature whether
past, present or contingent against the said employer and/or its officer.

In view hereof, I hereby move for dismissal of the above entitle case and
further request that the same dropped from the business calendar of this office.

IN WITNESS WHEREOF, I/We hereunto set my hand this 20th day of June at
Makati City.

CARDI BEE
Complainant

PAID IN THE PRESENCE OF:

CARDO BOY CARDI GIRL

SUBSCRIBED AND SWORN to before me this 20th, day of June, 2018 at

Makati City.

Notary Public

Doc. No. 125;

Page No. 12;
Book No. 12;
Series of 2018.