REPUBLIC of the PHILIPPINES

REGIONAL TRIAL COURT

__ JUDICIAL REGION
BRANCH __, CITY OF _____________

In re: PETITION FOR CORRECTION OF Case No. SP-

ENTRY IN CERTIFICATE OF LIVE
BIRTH

Petitioner

JURISDICTIONAL FACTS
The following exhibits are hereby formally offered for marking to establish the
jurisdictional facts of the instant Petition and for other matters.

PETITION composed of ____ (__) pages found on

Exhibit A -
pages 1 to __ of the record.

SIGNATURE OF PETITIONER found on page

Exhibit A-1 -
__ of the record.

Exhibit B - CERTIFICATE OF LIVE BIRTH attached as

ANNEX A and found on page __ of the record.

Exhibit B-1 - ENTRY FOR _____________

Exhibit B-2 - ENTRY FOR GENDER

Exhibit C - MEDICAL CERTIFICATE attached as ANNEX B

and found on page __ of the record.

Exhibit D -

Exhibit E -

Exhibit F -

Exhibit G -

Exhibit H -

Page 1 of 3
Exhibit I -

Exhibit J - NOTICE OF HEARING dated ____________

found on page __ of the record.

Exhibit J-1 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the Petitioner

Exhibit J-2 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the Counsel for
the Petitioner

Exhibit J-3 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the Solicitor
General

Exhibit J-4 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the Civil
Registrar General

Exhibit J-5 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the Office of
the Local Civil Registrar for the City of Roxas

Exhibit J-6 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the National
Census and Statistics Office.

Exhibit J-7 - REGISTRY RECEIPT NO. __________ dated

___________________ addressed to the Office of
the City Prosecutor for the City of Roxas.

Exhibit J-8 - REGISTRY RETURN CARD dated

___________________ from the Petitioner

Exhibit J-9 - REGISTRY RETURN CARD dated

___________________ from the Counsel for the
Petitioner

Exhibit J-10 - REGISTRY RETURN CARD dated

___________________ from the Solicitor General

Exhibit J-11 - REGISTRY RETURN CARD dated

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 ___________________ from the Civil Registrar
General

Exhibit J-12 - REGISTRY RETURN CARD dated

___________________ from the Office of the Local
Civil Registrar for the City of Roxas

Exhibit J-13 - REGISTRY RETURN CARD dated

___________________ from the National Census
and Statistics Office

Exhibit J-14 - REGISTRY RETURN CARD dated

___________________ from the Office of the City
Prosecutor for the City of Roxas

Exhibit K - ORDER OF PUBLICATION dated __________

found on page __ of the record.

Exhibit L - AFFIDAVIT OF PUBLICATION

Exhibit M - PUBLICATION DATED _______________ (First

week)

Exhibit M-1 - CLIPPING OF PUBLICATION

Exhibit N - PUBLICATION DATED _______________

(Second week)

Exhibit N-1 - CLIPPING OF PUBLICATION

Exhibit O - PUBLICATION DATED _______________

(Third week)

Exhibit O-1 - CLIPPING OF PUBLICATION

Page 3 of 3