Republic of the Philippines

REGIONAL TRIAL COURT

5th Judicial Region
Naga City

OFFICE OF THE EXECUTIVE JUDGE

IN RE: PETITION FOR APPOINTMENT

and COMMISSION as NOTARY PUBLIC
for the CITY OF NAGA in the PROVINCE OF CAMARINES SUR,

ATTY. LEO ARCHIVAL I. IMPERIAL,

Petitioner.
x --------------------------------------------------- x

PETITION
COMES NOW Petitioner to this Honorable Court, most respectfully
states that:
1. He is a citizen of the Philippines, born on April 17, 1985, over 21 years
of age and has completed and finished his law degree at the University
of Nueva Caceres;
2. He was admitted to the Philippine Bar on March 23, 2012 and was
assigned Attorney's Roll No. 60619, copies of the Certification of
Membership in the Philippine Bar issued by the Office of the Bar
Confidant (OBC) as well as the Certification as to no pending case
issued by the OBC are hereby attached as Annex A and B for
reference;
3. He has been a resident in the Philippines for more than one (1) year
and holds regular office at Zone 4, Cararayan, Naga City with mobile
number 09064421634, the office map sketch is hereby attached as
Annex C for reference;
4. He is a member of good standing of the Integrated Bar of the
Philippines (IBP), Camarines Sur Chapter, as evidenced by IBP Official
Receipt No. 936735 dated December 13, 2013 and the copies of the
Certification of good moral character issued by two (2) executive
officers of the local chapter of the IBP as well as the Certification from
the IBP National Office as to payment of IBP dues and as to no
pending administrative case/disbarment proceedings, are hereto
attached as Annex D, E and F respectively;

5. He has paid his Professional Tax for the current year and was issued
Professional Tax Receipt (PTR) No. 3682183 dated January 12, 2013, a
copy of which is herein attached as Annex G for reference;
6. He has paid the application fees for said Petition as evidenced by
Official Receipts Nos. 5103383 and 5103961, copies of which are
herein attached as Annex H, and has already secured a clearance
from the Regional Trial Court 5th Judicial Region issued on July 16,
2013,a copy of which is herein attached as Annex I;
7. He undertakes to immediately inform the Honorable Court of any
change in his address and/or telephone numbers;
8. He now desires to be appointed and commissioned as Notary Public
acting for and in the City of Naga, in the Province of Camarines Sur for
the term ending on December 31, 2015;
9. He has not been appointed Notary Public by any other Executive Judge
for the term applied for;
10. He has never been convicted of any crime involving moral turpitude;
and
11. He has affixed hereto three (3) facsimile signatures, as well as three
(3) passport-size unretouched color photographs with light background
taken within thirty (30) days of the application, herein attached as
Annex J.

PRAYER
WHEREFORE, Petitioner most respectfully prays that he be appointed
and commissioned as Notary Public for and in the City of Naga, in the
Province of Camarines Sur for the term ending on December 31, 2015.
Naga City, Philippines, ___________.

ATTY. LEO ARCHIVAL I. IMPERIAL

Petitioner

VERIFICATION AND CERTIFICATION

REPUBLIC OF THE PHILIPPINES)

Province of Camarines Sur) S.S.
City of Naga)
x-----------------------x
I, ATTY. LEO ARCHIVAL I. IMPERIAL, of legal age, Filipino, single,
and a resident of Zone 4 Cararayan, Naga City, Philippines, after being
sworn in accordance with law, hereby depose and say:
That I am the Petitioner in the above-entitled case; That I have caused
the preparation of the above Petition and I have read the same and knows
the contents thereof; That the allegations contained therein are true and
correct of my own personal knowledge.
That I further certify that: (a) I have not theretofore commenced any
other action or proceeding or filed any claim involving the same issues or
matter in any court, tribunal, or quasi-judicial agency and, to the best of my
knowledge, no such action or proceeding is pending therein; (c) if I should
thereafter learn that the same or similar action or proceeding has been filed or
is pending before the Supreme Court, the Court of Appeals, or any other
tribunal or quasi-judicial agency, I undertake to report such fact within five (5)
days therefrom to the court or agency wherein the original pleading and sworn
certification contemplated herein have been filed.
IN WITNESS WHEREOF, I have hereunto set my hand this
_____________ at _____________, Philippines.

ATTY. LEO ARCHIVAL I. IMPERIAL

Affiant

SUBSCRIBED AND SWORN to before me, this _____________, by

ATTY. LEO ARCHIVAL I. IMPERIAL who exhibited to me his Drivers License
No. E04-10-004680 issued at Naga City, Philippines on April 20, 2013.

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______;

SPECIMEN SIGNATURE

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