Republic of the Philippines

OFFICE OF THE CITY REGISTRAR

City of Davao

REPUBLIC OF THE PHILIPPINES)

CITY OF DAVAO ) S.S.

PETITION FOR CHANGE OF FIRST NAME

I, ANDRE DELA CRUZ, of legal age, Filipino, and a

resident of 121 Nickelodeon Street, El Rio Subd. Davao City,
after having been duly sworn to in accordance with law,
hereby declare that:

1. I am the petitioner seeking the change of first name

in my Certificate of Live Birth;

2. I was born on November 1, 2000 at Davao City,

Province of Davao del Sur;

3. The birth was recorded at Registry No. 12345;

4. The first name to be changed from ANDRE to

ANDREY;

5. The ground for The grounds for filing this petition

are the following:

a. The first name is extremely confusing to

write.
b. I am publicly known in the community with
that first name
c. The first name is ridiculous

6. I submit the following documents to support this

petition:

a. Certificate of Live Birth

b. Testimonies of the residents of Barangay
Buhay Subdivision

7. I have not filed any similar petition and that, to the

best of my knowledge, no other similar petition is
 pending with any LCRO, Court or Philippine
Consulate;

8. I have no pending criminal, civil or administrative

case in any court or quasi-judicial body;

9. I am filing this petition at the LCRO of Davao City,

Province of Davao del Sur in accordance with R.A.
No. 12345 and its implementing rules and
regulations.
 VERIFICATION

I, ANDRE DELA CRUZ, the petitioner, hereby certify that the

allegations herein are true and correct to the best of my
knowledge and belief.

ANDRE DELA CRUZ

Signature over printed name of petitioner

SUBSCRIBED AND SWORN to before me this 8th day of

February 2020 in the city of Davao, petitioner exhibiting his
LTO Driver’s License No. 12345 issued at Davao City on 15
April 2001
.

ATTY. NINO SANTOS

Administering
Officer