Professional Documents
Culture Documents
Exemption
Exemption
09
MANDATORY CONTINUING LEGAL EDUCATION COMMITTEE
4th Floor, IBP Building
15 Doa Julia Vargas Avenue
Ortigas Center, Pasig City
APPLICATION FOR EXEMPTION
1. Name: Roll No. IBP No.
2. Mailing Address:
3. Tele!one " Tele#a$ " Email Address:
%. &ro'nd #or E$em(ion:
)e*. 1+ R'le ," )e*. 2 R'le ," )e*. 3+ R'le ,: " -(!ers:
.. )(a(e se*i#i* gro'nd and/or 0's(i#i*a(ion:
12se seara(e s!ee( i# ne*essar34
5. Re6'ired a((a*!men(s o# (!is ali*a(ion
a. A'(!en(i*a(ed Cer(i#i*a(ion #rom -##i*e *on*erned 1#or )e*(ion 1 onl34
7. No(ari8ed A##ida9i( 1#or )e*(ion 2 onl34
*. No(ari8ed Medi*al Cer(i#i*a(e/Cer(i#i*a(ion 1#or illness and !3si*al disa7ili(3
'nder )e*(ion 34
d. Cer(i#i*a(e o# Admission and A**e(an*e 1#or os( grad'a(e s('dies a7road 'nder
)e*(ion 34.
e. No(ari8ed e$lana(ion/0's(i#i*a(ion 1#or ro9en e$er(ise in la:s and o(!er similar
gro'nds4
#. Pa3men( o# P 1+000.00 as e$em(ion #ee
,. I !ere73 *er(i#3 (!a( (!e a7o9e in#orma(ion are (r'e and *omle(e (o (!e 7es( o# m3
;no:ledge.
Prin(ed Name and )igna('re o# Ali*an( <a(e
Note:
1. This application must be eecute! un!e" oath an! #e"i$ie!.
%. I$ the applicant is appl&in' as a p"o$esso" o$ la( $o" ten &ea"s o" mo"e) he must
submit a !etaile! o$$icial se"#ice "eco"! in!icatin' the sub*ect+s tau'ht pe"
semeste" since the sta"t o$ his la( teachin'.
For (!e MCLE Commi((ee onl3:
A*(ion (a;en Aro9ed <isaro9ed
MCLE Form No. 09
Credi( 2ni(/s a:arded:
Commen(s:
1To 7e #iled in si$ 154 *oies4