REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

First Judicial Region
Branch 30
City of San Fernando, La Union

IN RE: PETITION TO USE THE

SURNAME OF FATHER AND FOR
THE CORRECTION OF ENTRY
OF THE CERTIFICATE OF LIVE
BIRTH OF JONATHAN REYES
DE GUZMAN UNDER REGISTRY
NO. 123456

JONATHAN REYES DE GUZMAN,

SPL. PROC. Case
Petitioner, No.777

PETITION TO USE
THE SURNAME OF
FATHER AND/OR
CORRECTION OF
ENTRY
– versus –

THE CITY CIVIL REGISTRAR OF

SAN FERNANDO CITY, LA UNION,
THE PHILIPPINE STATISTICS
AUTHORITY AND ALL
PERSONS/ENTITIES
WHO/WHICH MAY BE AFFECTED
THEREBY,

Respondents.
x----------------------------------------x

PETITION

PETITIONER, through the undersigned counsel, and

unto this Honorable Court, most respectfully states that:

THE PARTIES

1. Petitioner JONATHAN REYES DE GUZMAN is of legal

age, Filipino, single and a resident of Catbangen, City
of San Fernando, La Union;
2. Respondent CITY CIVIL REGISTRAR is included as a
party. It has the capacity to perform the civil
registration functions. It is where the fact of birth of
Petitioner was registered and where summons and
other legal processes may be served;

3. Respondent PHILIPPINE STATISTICS AUTHORITY

(PSA) is also included as a party. It carries out the
provisions and mandates of the Civil Registry Law. It
performs registration, correction, and issuance of
entries in all births, marriages, and deaths in the
Philippines;

FACTS OF THE CASE

4. Petitioner was born on October 14, 1997 in San

Fernando City, La Union to parents JENNIFER R. DE
GUZMAN and ROGELIO C. RIVERA;

5. Petitioner had been using “RIVERA” as his surname in

all his records;

6. Petitioner is aware that the name indicated in his

Certificate of Live Birth is JONATHAN REYES DE
GUZMAN. A copy of the Certificate of Live Birth of
petitioner is attached and marked as Annex “A”;

7. The parents of petitioner contracted marriage on

September 28, 1998. A copy of the Certificate of
Marriage is attached and marked as Annex “B”;

8. There is a need to file the instant Petition pursuant to

Rule 108 of the Revised Rules of Court as the
petitioner’s father, ROGELIO C. RIVERA, contracted a
previous marriage as reflected in the latter’s
CENOMAR Certificate of No Marriage (CENOMAR) by
the Philippine Statistics Authority (PSA). A copy of the
CENOMAR is hereto attached and marked as “Annex
C”;

9. Petitioner desires to continue using the surname of

his father. He intends to be continuously known as
“JONATHAN DE GUZMAN RIVERA”;

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 10. Petitioner only has good intentions in his bid to cause
the correction of entries in his Certificate of Live Birth
and the same is not made to avoid any criminal
liability.

PRAYER

WHEREFORE, premises considered it most respectfully

prayed before this Honorable Court to GRANT this instant
petition and issue an ORDER:

1. Directing the Respondents City Civil Registrar and

Philippine Statistics Authority to CHANGE and CORRECT the
entry in Petitioner’s Certificate of Live Birth;

2. Relating to Petitioner’s name, from “JONATHAN REYES

DE GUZMAN” to “JONATHAN DE GUZMAN RIVERA”;

Other reliefs, just and equitable, under the premises, are

likewise prayed for.

RESPECTFULLY SUBMITTED.

San Fernando City, La Union, Philippines, October 22,

2019.

JUAN DELA CRUZ

Counsel for the Petitioner
2nd Floor ABC Bldg.,
Catbangen, City of San Fernando, La Union
Roll No. 123456
IBP No. 1234567
PTR No. 1234567
MCLE Compliance Certificate No: v 12233445

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Copy furnished: (by registered mail, due to distance)

Office of the Solicitor General

134 Amorsolo St., Legaspi Village
Makati City, 1229

City Civil Registrar

City Hall, City of San Fernando, La Union

Philippine Statistics Authority

PSA Complex, East Ave. Diliman, Quezon City

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Republic of the Philippines )
Province of La Union ) sc.
City of San Fernando )
x-------------------------------------x

VERIFICATION/CERTIFICATION

I, JONATHAN DE GUZMAN, of legal age, single, Filipino,

and resident of Catbangen, City of San Fernando, La Union,
after having been duly sworn in accordance with law, deposes
and says that:

1. I am the petitioner in the above-entitled case;

2. I have caused the preparation of the PETITION;

3. I have read the contents of the Petition. The facts,

circumstances and allegations are true and correct to
my knowledge based on authentic documents on
hand;

4. I have not commenced any other action or proceeding

involving the same issues to any other court, tribunal
or agency;

5. No other action or proceeding is pending in any other

court, tribunal or agency;

6. I undertake to report within five days to this Honorable

Court if I learn that a similar action filed or pending
before any other court, tribunal or agency exist.

IN WITNESS WHEREOF, I have hereunto set my hand

this 22nd day of October 2019 at San Fernando City, La Union.

JONATHAN DE GUZMAN
Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of

October 2019 at San Fernando City, La Union. Affiant
exhibited to me his competent evidence of identity in the form
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 of his Philippine Passport bearing No. EB1234567 valid until
August 11, 2022, issued by the Department of Foreign Affairs,
Manila.

DOC. NO. 29 ATTY. MARIA MERCEDES

PAGE NO. 07 Notary Public
BOOK NO. 52 Until Dec. 31, 2019
SERIES OF 2019. PTR No. 5926415
IBP Lifetime No. 02455
Roll No. 75860
MCLE Compliance No. V0012345
G/F Wright Bldg., Diversion Rd,
Sitio 5, Brgy. Biday, San
Fernando City, La Union

GROUP 1 (ACTIVITY 3):

Abalos, Jarlenne G.

Anasario, Rosette

Capistrano, Julius Irvin, Manglapus

Cinence, Renz Jayson

Laigo, Diane Faye P.

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