REPUBLIC OF THE PHILIPPINES)

______________________________ ) S.S.

SWORN STATEMENT
OF PETITIONER’S COUNSEL OF RECORD

I, [Counsel of Record], of legal age, Filipino, with office address at

[Address of Counsel], Philippines, after having been duly sworn to in
accordance with law hereby freely depose and say that:—

1. I am the handling counsel of [Name of Petitioner], the petitioner

in Civil Case No. ____________________ (For: Declaration of Nullity of
Marriage), entitled “[Name of Petitioner] v. [Name of Respondent] ”;

2. I have personally verified petitioner’s residency, specifically at

[Address of Petitioner], and confirmed that the petitioner had been residing
thereat, for more than six (6) months prior to [date petition was filed] ,
when the instant petition was filed; and

3. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this [ date ], at [ place ], Philippines.

[Counsel of Record]
Affiant

SUBSCRIBED AND SWORN to before me this [ date ], at

[ place ], affiant exhibiting his [ valid ID ], bearing his
photograph and signature.

Doc. No.____
Page No._____
Book No._____
Series of 2019.