Republic of the Philippines     )
___________                     ) s.s.
                   VERIFICATION AND CERTIFICATION
                      AGAINST FORUM SHOPPING
                                         (with SPA)
      I, __________, after having duly sworn in accordance with law, state the
following:
      1. I am the duly authorized representative of the Petitioner, _____________,
         the Petitioner in the above-entitled case.
      2. Under such authority I have caused the preparation of this Petition;
      3. I have read its contents and the allegations therein are true and correct of
         my own 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.
      WITNESS MY SIGNATURE this _____________, in _____________.
                                                            Affiant
      SUBSCRIBED AND SWORN TO BEFORE ME this _____________ 2018, by
the Affiant who is personally known to the undersigned Notary Public.
      BY MY HAND AND SEAL on the date and place above stated.
Doc. No. ______
Page No. ______
Book No. ______
Series of 2018.