Professional Documents
Culture Documents
PETITION
Petitioner,
through
the
undersigned
counsel
and
to
this
1.
1 Lot 27 Millwood Ville Pulo, Cabuyao, Laguna and the mother and
guardian of her minor child KIYUKO CANDELARIA TERAUCHI;
whereas Respondent - Civil Registrars are public officers in-charge of
the registration and cancellation/correction of entries in the civil
registrar where the fact of birth of the said minor child was registered,
which registrar is located at Ground Floor, City Hall, City of
Dasmarias;
2.
3.
wedlock, could not utilize the surname of her father Kazuya Terauchi,
and that it is more convenient and easy to process the registration of
her childs birth if she was married with Kazuya. Petitioner supplied
erroneous information as regards the date and place of her marriage
with Kazuya Terauchi;
5.
Petitioner
misrepresented
in
her
application
for
the
registration of birth of her child that she and Kazuya Terauchi were
married on June 20, 1994 in Japan, when the truth of the matter is
that they were and have not been married to this date. Copy of the
Certification issued by the Civil Registrar General attesting to the fact
that Petitioner has not been married to Kazuya Terauchi as their
marriage does not appear in the National Indices of Marriage is hereto
attached as Annex B;
6.
7.
8.
PRAYER
WHEREFORE, premises considered, it is most respectfully prayed
to this Honorable Court that an Order be issued directing the herein
Respondent Civil Registrars to cancel the information supplied as
the date and place of marriage of parents in Entry No. 18 and to
correct Entry No. 20, particularly the printed name of the herein
Petitioner from PINKY TERAUCHI to PINKY CANDELARIA and to
correct the surname of the minor child from KIYUKO CANDELARIA
TERAUCHI to KIYUKO CANDELARIA in the Certificate of Live Birth of
her minor child Kiyuko.
Other reliefs just and equitable are likewise prayed for.
Cabuyao City for Dasmarias City. April __________, 2013.
1.
I am the Petitioner in the foregoing Petition and I have
caused the preparation of the same, the contents of which are all true
and correct to the best of my personal knowledge, information and
belief;
2.
I certify that neither have I commenced nor is there any
pending Petition of similar nature before any court, tribunal or quasijudicial agency, and if I should hereafter learn that the same or similar
Petition has been filed or is pending in any court, tribunal or quasijudicial agency, I shall report the fact within five (5) days therefrom to
this Honorable Court.
IN WITNESS WHEREOF, I have hereunto set my hand this
____________ day of April, 2013 in Cabuyao City.
PINKY CANDELARIA-NAKAYAMA
Affiant
NOTARY PUBLIC
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of _____;