REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
THIRD JUDICIAL REGION
OFFICE OF THE EXECUTIVE JUDGE
ANGELES CITY
IN RE: PETITION FOR NOTARIAL
COMMISSION OF ATTY. ROSANNA F.
BERBA IN AND FOR THE CITIES OF
ANGELES, MABALACAT AND
MUNICIPALITIES OF MAGALANG AND
PORAC, OF THE PROVINCE OF
PAMPANGA IN ACCORDANCE WITH
SECTIONS 1 AND 2 OF RULE III OF A.M.
NO. 02-8-13-SC (2004 RULES OF
NOTARIAL PRACTICE)
ATTY. SELENA GOMEZ APPLICATION NO.____________
Petitioner.
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PETITION
COMES NOW, PETITIONER SELENA GOMEZ, unto this Honorable Court,
most respectfully states that:
She is twenty-seven (27) years old, born on 21 January 1996, single, Filipino
citizen and presently residing at Brgy. Salapungan, Angeles City, Pampanga. Brgy.
Clearance is herein attached and made an integral part of this Petition as ANNEX “A”.
She is presently engaged as an associate lawyer in CRUZ and GOMEZ law
offices, McArthur Highway, Angeles City, Pampanga. Interior and Exterior photographs of
the office, Sketch are herein attached and made an integral part of this Petition as ANNEXES
“B”, “B-1”, “B-2”.
She is a member in good standing of the Philippine Bar having been admitted as
such on 17 June 2019, as shown by the Certificate of Membership in the Philippine Bar
issued by the Office of the Bar Confidant of the Supreme Court of the Philippines,
which contained her Roll of Attorney’s No. 123456. A copy of the Certificate is herein
attached and made an integral part of this Petition as ANNEX “C”.
She has paid the required Membership Dues and Building Fund Contribution to
the Integrated Bar of the Philippines, National Office for the Calendar Year 2023. A copy
of the Official Receipts issued by the IBP National Treasurer is herein attached and made an
integral part of this Petition as ANNEX “D”.
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She is a member of good standing of the Integrated Bar of the Philippines-
Pampanga Chapter as shown by the Certifications issued by IBP- Pampanga Chapter.
Copy of IBP- Pampanga Certification is herein attached and made an integral part of this
Petition as ANNEX “E”.
She has no pending administrative case before the Office of the Bar Confidant as
shown by the Certification issued by the Office of the Bar Confidant of the Supreme
Court. A copy of the Certification is herein attached and made an integral part of this Petition
as ANNEX “F”.
She has not been charged nor convicted in the first instance of any crime
involving Moral Turpitude in connection with her profession as shown by the NBI
Clearance, Prosecutor’s Clearance, Clearances from Municipal Trial Court in Cities and
Regional Trial Court of Angeles City. A copy of the Clearances are herein attached and made
an integral part of this Petition as ANNEXES “G”, “H”, “I” and “J”, respectively.
She has not applied nor been commissioned as Notary Public in any other
jurisdiction.
She has paid her Professional Tax for the year 2023 under Official Receipt No.
0123456 dated 3 January 2023. A copy of the Official Receipt issued by the City Treasurer’s
Office of Angeles City is herein attached and made an integral part of this Petition as ANNEX
“K”.
She has attached as ANNEXES “L” and “M” showing the specimen of her Official
and Short-hand signature, respectively.
She has attached three (3) passport-size colored photograph with light
background with the signature of the Petitioner at the bottom portion, taken not more
than thirty (30) days prior to the filing of this Petition as ANNEX “N”.
She has likewise attached the clear impressions of her dry seal with the receipt
issued by the manufacturer. The impressions of dry seal and the receipt of the manufacturer
are herein attached and made an integral part of this Petition as ANNEXES “O”and “P”.
She possesses all the qualifications and none of the disqualifications for the
Office of the Notary Public and has read, understood and is willing to abide with the
2004 Rules on Notarial Practice.
She has complied with all the requirements under Sections 1 and 2 of Rule III of
A.M. No. 02-8-13-SC and thus, most respectfully prays that this Application for Notarial
Commission for and in the Cities of Angeles and Mabalacat, Municipalities of Magalang
and Porac of the Province of Pampanga, be granted.
PRAYER
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WHEREFORE, it is most respectfully prayed that a Certificate of Authorization
to purchase Notarial Seal as provided under Section 9, Rule III and Certificate of
Authority for a Notarial Act under Section 1, Rule IX, both of the 2004 Rules on Notarial
Practice be issued in favor of the Petitioner.
Other relief and remedies are likewise prayed for under the premises.
RESPECTFULLY SUBMITTED.
Angeles City, 30 June, 2023.
SELENA GOMEZ
Petitioner
Roll No. 123456
IBP OR No. 12345 / 02 January 2023 /
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VERIFICATION AND CERTIFICATION AGAINST FORUM
SHOPPING
I, SELENA GOMEZ, of legal age, single, Filipino citizen and presently residing at
Brgy. Salapungan, Angeles City, Pampanga, after having duly sworn to in accordance
with law, hereby depose and state that:
1. I am the petitioner in the above-entitled Petition;
2. I have caused the preparation of the foregoing Petition;
3. The allegations therein are true and correct based on my personal
knowledge and authentic records;
4. To the best of my knowledge, there are no other pending Petition of the
same nature before any court, tribunal or quasi-judicial agency; and
5. Should I thereafter learn of any similar case pending before any other
court, tribunal or quasi-judicial agency, I shall promptly notify this Court within five (5)
days from discovery.
SELENA GOMEZ
Petitioner/Affiant
SUBSCRIBED AND SWORN to before me this
____________________at___________________________ by SELENA GOMEZ who
exhibited to me her Philhealth ID bearing her photograph and signature with No.
0123456 and who is known to me to be the same person who personally appeared and
signed before me the foregoing Verification and acknowledged to me that she has freely
and voluntarily executed the same.
NOTARY PUBLIC
Doc. No.____
Page No.____
Book No.___
Series of 2023
