Republic of the Philippines

City of Manila ) S.S

AFFIDAVIT OF LOSS

I, KATHRYN CHANDRIA MANUEL BERNARDO  of legal age, Filipino, single, and
a resident of 143 Pinaglabanan Street, Sta. Cruz, Manila, after having been sworn in accordance
with law, hereby depose and state THAT:

1. I am the owner of the love issued by DANIEL JOHN FORD PADILLA on

December 25, 2016;

2. Sometime after I received the aforesaid love, I put it in my heart together with all of
his promises and locked it;

3. When I tried to open my heart, the said love was missing. I asked the people I met
along the way if they have seen or find the missing love but they answered in
negative;

4. Despite my diligent effort to look for the said love, the same proved futile. Thus, I
considered it to have been lost and beyond recovery;

5. The said love was never confiscated nor used as a security to any obligation or
transaction;

6. I am executing this affidavit to attest to the truth of the foregoing statements and for
whatever legal purpose of intents this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 24th  day of

January 2018 at City of Manila, Philippines.

KATHRYN CHANDRIA MANUEL BERNARDO

 Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicated above.
Affiant exhibited to me her Passport with a Passport No. P4444656A with a validity date until
26th day of October 2022.

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 REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
NATIONAL CAPITAL JUDICIAL REGION
Branch 5
City of Manila

IN THE MATTER OF CORRECTION OF

ENTRIES IN THE CERTIFICATE OF
LIVE BIRTH OF
JAMES CARLOS AQUINO YAP JR.

KRISTINA BERNADETTE C. AQUINO

Petitioner,

---versus--- Special Proc. No. 2018-0127

CIVIL REGISTRAR OF MANILA AND

ALL PERSONS/ENTITIES WHO/WHICH
MAY BE AFFECTED THEREBY,
Respondents.
x--------------------------------------x

PETITION

Petitioner, through the undersigned counsel and to this Honorable Court, most
respectfully states that:

1. Petitioner is of legal age, Filipino, single, a resident of Blk. 1 Lot 2 Forbes Park,
San Antonio, Makati and the mother and guardian of her minor child  –   JAMES CARLOS
AQUINO YAP, JR.; whereas Respondent - Civil Registrars are public officers in-charge of the
registration and cancellation/correction of entries in the civil registrar where the fact of birth of
the said minor child was registered, which registrar is located at Ground Floor, City Hall, City of
Manila;

2. Petitioner conceived and gave birth to her child –   JAMES CARLOS AQUINO
YAP, JR. on April 19, 2007 at Manila Doctors Hospital, Ermita, Manila, out of wedlock with
James Carlos Agravante Yap, Sr., which fact of birth was registered on April 17, 2007 before the
Office of Respondent Civil Registrar of Manila under Civil Registry No. 17-1884. Copy of the
Certificate of Live Birth of James Carlos Aquino Yap, Jr. is h ereto attached as Annex “A;” 

3. Prompted by the misbelief that her child, being born out of wedlock, could not
utilize the surname of her father –  James Carlos Yap, Sr., and that it is more convenient and easy
to process the registration of her child’s birth if she was married w ith James. Petitioner supplied
erroneous information as regards the date and place of her marriage with James Carlos A. Yap,
Sr.;
REPUBLIC OF THE PHILIPPINES)
CITY OF MANILA )S.S

VERIFICATION AND CERTIFICATION

AGAINST FORUM-SHOPPING

I, KRISTINA BERNADETTE COJUANGCO AQUINO, single, of legal age, Filipino

and a resident of Blk. 1 Lot 2 Forbes Park, San Antonio, Makati, after having been duly sworn to
in accordance with law, do hereby depose and state that:

1. I am the Petitioner in the foregoing Petition and I have caused the preparation of
the same, the contents of which are all true and correct to the best of my personal knowledge,
information and belief;

2. I certify that neither have I commenced nor is there any pending Petition of
similar nature before any court, tribunal or quasi-judicial agency, and if I should hereafter learn
that the same or similar Petition has been filed or is pending in any court, tribunal or quasi-
 judicial agency, I shall report the fact within five (5) days therefrom to this Honorable Court.

IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of January, 2018 in
Manila.

KRISTINA BERNADETTE C. AQUINO

Affiant

SUBSCRIBED AND SWORN to before this 23rd  day of January 2018, Manila. Affiant
exhibited to me her Passport with Passport No. Passport No. P5555767B with a validity date
until 13th day of January 2028.

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