Verification and Certification of

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VERIFICATION AND CERTIFICATION OF

NON-FORUM SHOPPING

I, VIRGINIA M. BELLEZA, of legal age, Filipino, with


residence and post office address at National Road, Brgy. Special
District, Municipality of Jalajala, Province of Rizal after having duly
sworn to in accordance with law, hereby depose and say that:
1. I am the Petitioner in the above-entitled case;
2. I have caused the preparation of the foregoing Petition for
Review and have read the same and know the contents thereof and
that the allegations therein are true and correct;
3. I have not commence any other action or filed any claim
involving the same issues in the Supreme Court, Court of Appeals
or any divisions thereof or in any court, tribunal or quasi-judicial
agency and to the best of my knowledge no such other action or
claim is pending therein;
5. If I should thereafter learn that the same or similar action
or claim has been filed in the Supreme Court, Court of Appeals or
any divisions thereof or in any court, tribunal or quasi-judicial
agency, I hereby undertake to report such fact within five (5) days to
this Honorable Court;

Jalajala, Rizal, March 2014.


VIRGINIA M. BELLEZA
Affiant
SUBSCRIBED AND SWORN TO before me this ____ day of
________________, at _______________, affiant exhibiting to me her
Identification Card No. ________ issued on ________ at _____________.

Notary Public

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