(Caption and Title)

PETITION FOR LEGAL SEPARATION

Petitioner thru counsel, and unto this Honorable Court, respectfully alleges:

1. That the petitioner is a resident of ______________________________;

2. That the petitioner and the respondent were legally married in
___________________ on ____________________;
3. That out of said marriage, _____ children were born, to wit:
_________________ born on _______________; __________________
born on __________________, etc.;
4. That during said marriage, the following properties had been acquired:
_______________________;
5. On or about _____________________, the respondent committed an act of
(Adultery/Concubinage) as defined in the Revised Penal Code, for which
he/she was duly convicted by the Regional Trial Court of _____________ in
Criminal Case No. ___________ on ___________, judgment of which had
already become final;
6. That petitioner has never condoned or committed such act of
Adultery/Concubinage on the part of respondent;
7. That the facts of this case render the reconciliation of the parties highly
improbable.

WHEREFORE, it is respectfully prayed:

(a) That pending these legal separation proceedings, the respondent be

deprived of his/her right to manage the conjugal partnership and that
adequate provision be made out of the conjugal property for the care and
support of the minor children, _______________;
(b) That after due hearing, a decree of legal separation be issued by this
Honorable Court, ordering: (1) That the petitioner shall be entitled to live
separately from the respondent, without dissolution, however, of the
marriage bond; (2) That the conjugal partnership be dissolved and
liquidated, depriving the respondent of his/her share of the conjugal
partnership profits and awarding the same to the above-name children;
(3) That the custody of the minor children be awarded to the petitioner;
and
(c) That such other relief just and equitable be granted.

(Venue, date, signature)

(Verification and Certification)