REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

Davao City
Branch ___
Davao City

In the Matter of Petition for Change of Birthdate

Of ____________ from_____to___________

SP. PRO:__________

_________________________
Petitioner.
X-------------------------------------------X

PETITION

COMES NOW, Petitioner, through the undersigned counsel and unto the
Honorable Court, most respectfully states that:

1 – The petitioner is of age, single and a resident of ______________________;

2 – He has been a bona fide resident of the City of Davao since the year _____,
or for at least ____ years prior to the date of filing of this petition;

3 – The petitioner was born on _______ and his father’s name is ________ while
his mother’s name is __________. His birth certificate showed that he was born on
_________, attached herein is a true copy marked as Annex “A”. His school records
carried the birthdate of ______, attached herein is a true copy marked as Annex “B”;

4 – The Petitioner desires to change his birthdate from _____ to _______ since it
his true birthdate as indicated in his birth certificate and to prevent confusion in his
government identification and transactions that involves his birthdate;

WHEREFOR, it is respectfully prayed that, after due notice and publication in

accordance with the Rules of Court, and hearing this Honorable Court adjudge that
the Petitioner’s birthdate be change from _______ to _________;

CITY OF DAVAO, June _____, 2018.

 Counsels for Petitioner

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, ___________ of legal age, and a resident of ______________, under oath

declare that:

1 – I am the Petitioner in the above-entitled case;

2 – I have caused the preparation of this Petition;

3 – I have read it and its contents are true and correct of my personal knowledge
and/or based on authentic records; and

4 – I have not earlier commenced a similar action for the same cause with any
other court, tribunal or quasi-judicial agency and, to the best of my knowledge, no
such action or proceeding is pending with any other court, tribunal or quasi-judicial
agency; and if I should learn that a similar action or proceeding has been filed or is
pending before any other court, tribunal or quasi-judicial agency, I hereby undertake
to notify this Honorable Court within five (5) days from such notice.

_____________________

SUBSRIBED AND SWORN TO before me this _______, in the City of Davao,

Petitioner appeared before me with his Government issued identification bearing
number _________.