You are on page 1of 37

REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT


FOURTH JUDICIAL REGION
BRANCH 54
LUCENA CITY

IN THE MATTER OF
PETITION FOR WRIT OF
HABEAS CORPUS

SPEC. PROC. CASE NO. 12345


FOR: WRIT OF HABEAS CORPUS

SUSAN DELA CRUZ,


Petitioner,
x-------------------------------------------------x

PETITION FOR WRIT OF


HABEAS CORPUS

COMES NOW the petitioner by the undersigned counsel, and unto this
Honorable Court, respectfully avers:

1. That the Petitioner is of legal age, and a resident of Lucban,


Quezon, where she may be serve court orders and processes,
while the Respondent is of legal age, and a resident of 123 Alba
St., Makati City, where he may be served summons, court orders
and processes;

2. That petitioner SUSAN DELA CRUZ is the mother of JUAN


DELA CRUZ, a minor, 3 years of age, under custody and residing
at respondent’s residence, at 123 Alba St. Makati City. Copy of
the Certificate of Live Birth is hereto attached and marked as
Annex “A”;

3. That the petitioner’s son, JUAN DELA CRUZ, in whose behalf


this application is being made, is actually restrained of his liberty
by the respondent at the latter’s residence in 123 Alba St. Makati
City;

4. That Article 213 of the Family Code of the Philippines provides,


that in case of separation of the parents, parental authority shall
be exercised by the parent designated by the court. The court
shall take into all relevant considerations, especially the choice of
the child over seven years of age, unless the parent chosen is
unfit;

5. That under seven, no mother shall be separated from a child


seven years of age……….. In all controversies regarding the
custody of minor, the foremost consideration is the moral,
physical and social welfare of the child concerned, taking into
account the resources and moral as well as standing of the
contending parents. Never has the Supreme Court deviated from
the criterion;

6. That such restraint of liberty of JUAN DELA CRUZ, by the


respondent infringe/violates the fundamental right of the
mother

7. That the petitioner through counsel has exhausted all efforts


available at law, and that he has no other pain, speedy, and
adequate remedy to protect his personal rights except by his
application for a Writ of Habeas Corpus.

WHEREFORE, Petitioner prays that a Writ of Habeas Corpus be issued by


this Honorable Court, directed to respondent, commanding the latter to have the
body of the minor JUAN DELA CRUZ , before this Court at the time and place
therein specified, and to summon the respondent then and there to appear and to
show cause of the detention of said petitioner; and that after due proceedings,
said JUAN DELA CRUZ be restored to his liberty and forthwith discharged from
confinement.

Respectfully Submitted.
Lucena City, June 13, 2011

ATTY. HARRY POTTER


Counsel for the Petitioner
St. Mary’s Business Center, Room 6-8,Perez
Street, Lucena City
IBP No. 12345/ 01-05-07/Quezon Province
PTR No. 4567/ 03-02-07/Quezon Province
VERIFICATION AND CERTIFICATION
AGAINST NON- FORUM SHOPPING

I, SUSAN DELA CRUZ, of legal age, Filipino, and a resident of 456 Balba
St. Lucban, Quezon, after being duly sworn to in accordance with law, depose and
says:

That I am the petitioner in the above-entitled case, that I have caused the
preparation of the preparation of the foregoing petition and understood the
contents thereof, and I hereby declare that all the allegations contained therein
are true and correct according to my knowledge and belief.

Furthermore, I hereby certify that I have not filed nor caused to be filed a
similar case involving the same issues in the Supreme Court, Court of Appeals or
any tribunal or agency, I shall inform the Court, tribunal or agency of such fact
within five (5) days thereof.

Susan Dela Cruz

SUBSCRIBED AND SWORN to before me this 1st day March 2011 at


Lucena City, affiant exhibiting to me her Community Tax Certificate No. 2345
issued on March 3, 2011, at Lucena City, Quezon.

Doc. No. 1 ;
Page No. 2 ;
Book No. 3 :
Series of 2011.
REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
NATIONAL CAPITAL JUDICIAL REGION
BRANCH 54
MAKATI CITY

IN THE MATTER OF :
WRIT OF KALIKASAN WITH
PRAYER FOR TEMPORARY
ENVIRONMENTAL PROTECTION
ORDER

JUAN DELA CRUZ, PEDRO DELA


CRUZ, KRISTINA CORONA, HUBERT
ONG, STEFANO MENDEZ, INIGO
DIZON, ALBERTO SISON, JUANA
MIGUEL, Petitioners,

 versus –

MANILA ELECTRIC COMPANY


(MERALCO), BARANGAY CHAIRMAN
CESAR S. TOLEDANES, in his capacity
as Barangay Chairman of Barangay 183,
Zone 20, Villamor, Pasay City,
BARANGAY COUNCIL OF BARANGAY
183, ZONE 20, VILLAMOR AIR BASE, SPEC. PROC. CASE NO. 123
PASAY CITY, NORMITA CASTILLO
and AMANTE C. CACACHO, in their FOR: PETITION for WRIT
capacity as Members of the Barangay
Council of Barangay 183, Zone 20, Villa
OF KALIKASAN
Respondent.
x-------------------------------------------x

PETITION FOR
WRIT OF KALIKASAN

COMES NOW the petitioners by the undersigned counsel, and unto this
Honorable Court, respectfully avers:

8. Petitioners are residents and inhabitants of Barangay 183-


Villamor, Zone 20, Pasay City and Magallanes Village, Makati
City, all of legal age, Filipinos, with capacity to sue, and residents
of the following addresses, respectively:

JUAN C. DELA CRUZ


40 Mata St. cor. Manlunas Extension, Barangay Villamor,
Pasay City
PEDRO DELA CRUZ
P 36-08 9th cor. 2nd Sts., Barangay Villamor, Pasay City
KRISTINA CORONA
Barangay Villamor, Pasay City
HUBERT ONG
F11 4th 21st St., Villamor Air Base,Pasay City
STEFANO MENDEZ
P36-10 9th St., Villamor Air Base,Pasay City
INIGO DIZON
B85 L9, 12-27th St., Villamor Air Base,Pasay City
ALBERT SISON
P-11-24 3rd St., Villamor Air Base,Pasay City
JUANA MIGUEL
U203 EAM Apratments 6th St., Villamor Air Base, Pasay City

9. Petitioners may be served with the orders, resolutions, notices


and processes of this Honorable Court through their counsel of
record, Atty. H. Harry L. Roque, Jr., at Roque and Butuyan Law
Offices, 1904 Antel Corporate Centre, 121 Valero Street, Salcedo
Village, 1227 Makati City, Philippines.

10. Respondent MANILA ELECTRIC COMPANY (MERALCO) is a


domestic corporation created and organized pursuant to the laws
of the Republic of the Philippines with principal office address at
MERALCO Building, Ortigas Avenue, Pasig City, where it may be
served with summons and other processes of this Honorable
Court.

11. Respondent BARANGAY CHAIRMAN CESAR S. TOLEDANES is


the Barangay Chairman of Bgy. 183, Zone 20, Villamor, Pasay
City where he may be served with summons and other processes
of the Honorable Court.

12. Respondent BARANGAY COUNCIL OF BARANGAY 183, ZONE


20, VILLAMOR, PASAYCITY, composed of:

a. Respondent RUTH M. CORTEZ, of legal age, Filipino;


b. Respondent RICARDO R. DIMAANO, of legal age, Filipino;
c. Respondent LEONARDO A. ABAD, of legal age, Filipino;
d. Respondent NORMITA CASTILLO, of legal age, Filipino; and
e. Respondent AMANTE C. CACACHO, of legal age, Filipino,
are holding office at the Barangay Hall of Barangay 183 located at
Barangay 183, Zone 20, Villamor, PasayCity, where they may be
served with summons and other processes of this Honorable Court.

13. Respondent MANILA INTERNATIONAL AIRPORT


AUTHORITY (MIAA) is a government agency created and
organized pursuant to the laws of the Republic of the Philippines,
vested with the power to administer and operate the Ninoy
Aquino International Airport III (NAIA 3), and with principal
office address at MIAA Administration Building, NAIA Complex
Pasay City, where it may be served with summons and other
processes of the Honorable Court.
14. Barangay 183 Zone 20, Villamor, Pasay City (hereinafter referred
to as “Barangay 183”, for brevity) used to be part of the Villamor
Air Base. It was thereafter converted into a private residential
land pursuant to Republic Act No. 7227, otherwise known as “An
Act Accelerating the Conversion of Military Reservations Into
Other Productive Uses, Creating the Bases Conversion And
Development Authority For This Purpose, Providing Funds
Therefor And For Other Purposes”. As such, the said parcel of
land was subdivided and afterwards sold and awarded to its
inhabitants, including herein Petitioners.

15. Magallanes Village (hereinafter referred to as “Magallanes Village”, for


brevity) is a residential area located in Makati City adjacent to
Barangay 183.

16. The Petitioners are existing residents and inhabitants of Barangay 183
and Magallanes Village. Some of them have likewise established their
respective businesses and livelihood therein.

17. On 13 July 2009, without the prior authority from and approval by
Respondent Barangay Council of Barangay 183, Zone 20, Villamor Air
Base, Pasay City (hereinafter referred to as “Respondent Barangay
Council”) and without the prior consultation with the constituents of the
barangay, Respondent Barangay Chairman Cesar S. Toledanes
(hereinafter referred to as “Respondent Toledanes”) issued a Barangay
Working Permit Clearance “for the installation of 115 KV sub-
transmission lines and poles at the10th and 12th Streets of Barangay
183.”[2]

18. Belatedly, however, on 02 September 2009, Respondent Barangay


Council, composed of Respondents Cesar Toledanes, Ruth Cortez,
Ricardo Dimaano, Leonardo Abad, Normita Castillo and Amante C.
Cacho, passed Barangay Resolution No. 40-S-2009, authorizing
Respondent Toledanes to issue a Barangay Permit authorizing
respondent MERALCO to install high voltage power lines and poles at
the 10thand 27th Streets of Barangay 183.[3] Similar to the Working
Permit Clearance issued, Barangay Resolution No. 40-S-2009 was
issued without a prior consultation with the constituents of the
barangay.

19. Also, despite the close proximity of the installation of the high tension
wires and poles to the nearby Magallanes Village in Makati City, the
residents and inhabitants of the same were not notified or consulted
with respect to such plans.
20. Thus, sometime in August 2010, Respondent MERALCO began
erecting towering posts along the 10th, 12th and 27th streets of
Barangay 183 and lining the perimeter wall between Barangay 183
andMagallanes Village.[4] The thirty (30) foot-high poles will hold the
transmission lines that will supply more or less one hundred fifteen
(115) Kilovolts (KV) of electricity to the Ninoy Aquino International
Airport III (NAIA 3).

21. Petitioners were not informed that Respondent MERALCO was going
to erect such posts in Barangay 183 either by Respondent MERALCO,
Respondent MIAA, who administers and operates the Ninoy Aquino
International Airport III (NAIA 3), and Respondents Toledanes, Ruth
Cortez, Ricardo Dimaano, Leonardo Abad, Normita Castillo and
Amante C. Cacacho, who are the barangay officials of Barangay 183.
As such, Petitioners were surprised to find out Respondent MERALCO
had already begun erecting the said posts without their knowledge and
without public discussion.

22. The high tension transmission lines shall traverse the entire 10th and
12th streets of Bgy. 183, and shall pass along the concrete wall
separating Barangay 183 of Pasay City and Magallanes Village of
Makati City.

23. On 18 October 2010, Petitioner Gemma dela Cruz, on behalf of the


other Petitioners, sent a letter to Respondents Toledanes, Cortez,
Dimaano, Abad, Castillo and Cacacho, appealing for the recall of the
Barangay Working Permit and Resolution No. 40-S-2009 earlier issued
by them.[5] This, however, proved futile.

24. The alarming presence of the towering posts being erected in close
proximity to–that is, as near as one (1) meter from–the respective
properties of Petitioners-Residents of Bgy. 183 and less than ten (10)
meters from the respective properties of Petitioners-Residents of
Magallanes Village, and the hazardous effects of the high tension wires
to their health and safety, bring Petitioners to seek the intervention of
this Honorable Court.

25. Due to the urgency of the situation, as the installation and


energizing of the high tension wires will be completed by
December 2010, there is a need to protect the Petitioners from
the hazardous and ill effects of the same.

26. That the petitioner through counsel has exhausted all efforts
available at law, and that he has no other pain, speedy, and
adequate remedy to protect his personal rights except by his
application for a Writ of Kalikasan and to issue a Temporary
Environmental Protection Order (TEPO), which is a feature
introduced by the new Rules of Procedure for Environmental
Cases (AM No. 09-6-8-SC), under which their petition was filed.
A TEPO will prohibit the further installation of new poles and
transmission lines while the case is pending with the court.

WHEREFORE, Petitioners pray immediately the filing of this petition, a


Temporary Environmental Protection Order (TEPO) and or a Writ of Kalikasan
be issued, ordering Respondents and any person acting on their behalf, to cease
and desist from conducting excavation works, installing poles and transmission
lines along the entire stretch of 10th, 12th and 27th Streets of Barangay 183, Zone
20, Villamor, Pasay City and from energizing and transmitting high voltage
electric current through the said powerlines .

Petitioners also pray for such other reliefs as are just and equitable under
the premises.

Makati City for the City of Manila, 11 November 2010.

Respectfully Submitted.

ROQUE AND BUTUYAN LAW OFFICES


Counsel for Petitioners
Unit 1904 Antel 2000 Corporate Centre
121 Valero Street, Salcedo Village
Makati City 1227
mail@roquebutuyan.com
Tel. No. 02 887 4445/887 3894
Fax No. 02 887 3893

By:
H. HARRY L ROQUE, JR.
Roll No. 36976
PTR No. 2115877, 01.13.10, Makati City
IBP No. 499912, Makati City, Lifetime Member
MCLE Exemption No. III-001000, 04.26.10
DEXTER DONNE B. DIZON
Roll No. 54013
PTR No. 2115880, 01.13.10, Makati City
IBP No. 811903, 01.12.10, Laguna
MCLE Compliance No. III-0013474, 04.21.10
Copy furnished:
MANILA ELECTRIC COMPANY (MERALCO)
MERALCO Building
Ortigas Avenue, Pasig City
BARANGAY CHAIRMAN CESAR S. TOLEDANES
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
BARANGAY COUNCIL OF BARANGAY 183
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
RUTH M. CORTEZ
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
RICARDO R. DIMAANO
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
LEONARDO A. ABAD
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
NORMITA CASTILLO
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
AMANTE C. CACACHO
Barangay Hall
Barangay 183, Zone 20, Villamor
Pasay City
MANILA INTERNATIONAL AIRPORT AUTHORITY (MIAA)
MIAA Administration Building
NAIA Complex Pasay City
EXPLANATION ON SERVICE BY REGISTERED MAIL
Due to distance, time constraints and lack of messengerial services, this Petition
for Writ of Kalikasan is being served on the Respondents by registered mail.

VERIFICATION AND CERTIFICATION


AGAINST NON- FORUM SHOPPING

I, JUAN DELA CRUZ, of legal age, Filipino, and a resident of 456 Balba St.
Lucban, Quezon, representing the petitioners, after being duly sworn to in
accordance with law, depose and says:

That I am the petitioner in the above-entitled case, that I have caused the
preparation of the preparation of the foregoing petition and understood the
contents thereof, and I hereby declare that all the allegations contained therein
are true and correct according to my knowledge and belief.
Furthermore, I hereby certify that I have not filed nor caused to be filed a
similar case involving the same issues in the Supreme Court, Court of Appeals or
any tribunal or agency, I shall inform the Court, tribunal or agency of such fact
within five (5) days thereof.

JUAN DELA CRUZ

SUBSCRIBED AND SWORN to before me this 1st day March 2011 at


Lucena City, affiant exhibiting to me her Community Tax Certificate No. 2345
issued on Makati City for the City of Manila, 11 November 2010.

Doc. No. 1;
Page No. 2;
Book No. 3:
Series of 2010.

Roque & Butuyan Law Offices


1904 Antel Corporate Center
121 Valero Street, Salcedo Village
1227 Makati City, Philippines
‘ +632.8873894 7 +632.8873893
: mail@roquebutuyan.com
Republic of the Philippines
SUPREME COURT
Manila

IN THE MATTER OF:


PETITION FOR THE WRIT OF
HABEAS DATA IN FAVOR OF
MELLISA C. ROXAS WITH PRAYERS
FOR PROTECTION ORDERS
INSPECTION OF PLACE, AND
PRODUCTION OF Inspection OF
PLACE, AND PRODUCTION OF
DOCUMENTS AND PERSONAL
PROPERTIES DOCUMENTS AND
PERSONAL PROPERTIES

JUAN DELA CRUZ, SPEC.PROC. CASE NO. 54321


Petitioner, FOR: PETITION FOR THE
HABEAS DATA
x---------------------------------------------x

PETITION FOR WRIT


OF HABEAS DATA

COMES NOW the petitioner by the undersigned counsel, and unto this
Honorable Court, respectfully avers:

27. That petitioner is a of resident in Quezon City and is the


aggrieved party and victim in this petition and be served with
processes of this Honorable Court and her attorneys-in-fact and
her lawyer's address and Second Floor, Erythrina Bldg., 1 Stable
Maaralin corner streets, Barangay Central, Diliman, Quezon City;

28. Respondents are: GLORIA MACAPAGAL ARROYO, the


President of the Philippines and who CAN be served with
summons and Other matters and court processes and
Malacañang Palace Manila, SEC. Manila, SEC. GILBERT
TEODORO, Secretary of Defense, and who can be served with
summons and other court processes and matters at Camp
Aguinaldo, EDSA, Quezon City, GEN. VICTOR S. VICTOR S.
IBRADO, Ibrado, Commanding General of the Armed Forces of
the Philippines,who can be served with summons and other court
processes and matters and Camp Aguinaldo, EDSA, Quezon City,
P / DIR. GEN. Jesus Verzosa, the Director General of the
Philippine National Police, and who CAN be served with
summons and Other court matters and Camp Crame, EDSA,
Quezon City, LT. GEN. GEN. DELFIN N. Delfin N. BANGIT, the
Commanding General of the Bangit, Philippine Army, and who
CAN be served with summons and Other court matters and Fort
Bonifacio, Taguig City, MM, PCSUPT DELA CRUZ, the Regional
Director of the Dela Cruz, the Regional Director of the Philippine
National Police Region III Office, and who CAN be served with
summons and court processes and Other matters and Camp
Olivas, San Fernando, Pampanga, MAJ. GEN. GEN. RALPH
Ralph VILLANUEVA, Commanding General of the Philippine
Army's 7th Infantry Division, and who CAN be served with
summons and Other court matters and Fort Magsaysay, Laur,
Nueva Ecija, PSSUPT. RUDY GAMIDO LACADIN, Police
Director of the Province of Tarlac, and who CAN be served court
summons and Other processes and matters and Camp
Macabulos, Tarlac City, Tarlac, and Certain Persons WHO GO BY
THE NAMES DEX, RC, and Being members or officers of the
Armed Forces of the Philippines CAN be served summons, court
processes and matters and Camp Aguinaldo, EDSA, Quezon City;
MELISSA C. MELISSA C. ROXAS with two other companions,
Juanito Carabeo and John Edward, were abducted and
kidnapped by about 15 armed men with strong evidence of being
military Personnel on the early afternoon of May 19, 2009 at La
Paz, Tarlac Philippines and were forcibly brought to a place
which is strongly believed to be Fort Magsaysay;

29. Petitioner and her companions were abducted and kidnapped


without any legal ground and basis for authority being believed
by their abductors and kidnappers to be members of the CPP -
New People's Army;

30. Petitioner underwent tactical interrogation and was tortured


(Attached is her affidavits and medical certificates as Annexes
"A" and "B" with reservations on the marking of a Book entitled
Love in Times of Cholera as Annex "A-1", the Holy Bible St.
James Version as James Version as Annex "A-2", the handcuffs
with lot number 4760 and made in Taiwan, as Annex "A-3", a slip
of paper with an email address and password as Annex "A-4", a
blouse as Annex "A-5" and a pair of white shoes as Annex "A-5")
heavily Causing trauma and depression Fear for her life and;

31. The lives, liberty and security of Petitioner and her uncle and
family have been threatened by the abductors and kidnappers of
Petitioner and are in real danger and imminent threat; The
distance of the travel and the sounds heard by Petitioner in the
place Where the Petitioner and the two men were brought as well
as the buildings are described by Petitioner places inside Fort
Magsaysay;

32. When Petitioner was abducted, made right investigations of her


disappearance and reported the matter to police authorities
(attached hereto is the police report as Annex "C");

33. The initial reports tallied with the same patterns of abduction
and kidnapping done by military forces to commit the crime with
impunity and brazenly done Which CAN be done only by people
who authorities are;

34. The police and military authorities and the Office of the
President have not done anything to investigate their personnel
in the commission of this dastardly crime and if any investigation
was made, the investigation was shallow and pro-forma without
any intention of really solving the crime;

35. The Petitioner has been declared by those who abducted her as
being in the Order of Battle (OB) and has been investigated to be
a member of the NPA - without the presence of counsel despite
persistent demand for one. The labeling and listing her in the OB
is a violation of her privacy rights and list and label THESE
MUST BE expunged from all records taken during the said
tactical interrogation;

36. A camera containing a memory card, the iPod, the laptop and
the journal, contain materials Which private to the petitioner,
which were taken from her be returned including the
sphygmomanometer, stethoscope, the medicine, the P 15,000.00
cash robbed from her;

37. That Petitioner has exhausted all efforts legally available and that
there is no other plain, speedy, and adequate remedy except by
this application for a writ of habeas data.

38. Furthermore, to order that the pertinent records or connected in


any way to MELISSA C.ROXAS, or any name which might sound
or Abduction, or any name or sound which might approximate
the same in the hands of respondent should expunged and
forever Should and Should be disabused not be used anymore.

39. Finally, to return to respondent the camera containing a memory


card, the IPOD, the laptop and the journals were taken from her,
Which contain materials private to the petitioner, be returned
including private including the sphygmomanometer,stethoscope,
the medicine, and the the Ps. 15,000.00 cash robbed from her;

WHEREFORE, it is respectfully prayed that:

 A Writ of Habeas Data be immediately issued and prayers for


production of inspection of place, and production of documents
and personal properties documents and personal properties.
 After due hearing, an order be issued destroying the database or
information or files being kept by the respondent.
 An order be likewise issued after hearing, enjoining respondent
from conducting further surveillance and collection of information
on the petitioner.
 Other reliefs just and equitable are likewise prayed for.

DONE. QUEZON, CITY, PHILIPPINES; MAY 28, 2012.

ENRIQUE DE SILVA
PTR 5441971, 1/07/12, Prov. Cebu
Lifetime MEMBER NO. 01032, Cebu
Second Flr., Erythrina Bldg.,
corner Matatag sts., Stable Barangay
Central, Quezon City
Roll 37453, Page 491, Book XV
MCLE Compliance II 001709, 12/3/2009
VERIFICATION AND CERTIFICATION
AGAINST NON- FORUM SHOPPING FOR PETITION
FOR WRIT OF HABEAS DATA

Republic of the Philippines)


Quezon City .......................) SS

I, MELISSA C. ROXAS, of legal age, US Citizen and a temporary resident


of Quezon City, after having been sworn to in accordance with law, do hereby
depose and state that: She is the Petitioner in the above-entitled Petition; She
has caused the preparation of the above Petition and has read and knows the
same, the allegations therein are true and correct of her own personal knowledge,
she has not filed nor commenced any action or proceedings involving the same
issues nor is there any proceedings or action pending before the Supreme Court,
Court of Appeals or in any tribunal or agency with the same issues and parties
and in the event that Petitioner would know that there is an action or proceedings
involving the same issues and parties, she undertakes to notify this Honorable
Court of the pendency of the said action within five (5) days from knowledge
thereof.

That I am the petitioner in the above-entitled case, that I have caused the
preparation of the preparation of the foregoing petition and understood the
contents thereof, and I hereby declare that all the allegations contained therein
are true and correct according to my knowledge and belief.

Furthermore, I hereby certify that I have not filed nor caused to be filed a
similar case involving the same issues in the Supreme Court, Court of Appeals or
any tribunal or agency, I shall inform the Court, tribunal or agency of such fact
within five (5) days thereof.

MELISSA C. ROXAS

SUBSCRIBED AND SWORN to before me this 1ST day JUNE 2012 at


QUEZON CITY, PHILIPPINES, affiant exhibiting to me her Community Tax
Certificate No. 12345 issued on JULY 1, 2012, at MANILA.

Doc. No. 1 ;
Page No. 2 ;
Book No. III :
Series of 2012.
REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
FOURTH JUDICIAL REGION
BRANCH IV
LUCENA CITY

IN RE: IN THE MATTER OF THE


GUARDIANSHIP OF HER MINOR
CHILDREN

SPECIAL PROCEEDING NO. 12345


FOR: PETITION FOR GUARDIANSHIP
LISA SIMPSON-DIZON,
Petitioner.
x-------------------------------------------------x

PETITION FOR GUARDIANSHIP

The Petitioner, through the undersigned counsel, and unto this Honorable
Court, most respectfully alleges:

40.That Petitioner LISA SIMPSON-DIZON, is of legal age, Filipino, widow


and a resident of No.11 P. Paterno St., Tayabas, Quezon;

41. That LISA SIMPSON-DIZON and BART DIZON were married in


Sariaya, Quezon on June 20, 1994, and was solemnized before Mayor
Juanito M. Manigbas. Photocopy of Certificate of Marriage is hereto
attached and marked as Annex “A”, and made an integral part hereof;

42. That during the marriage of LISA SIMPSON-DIZON and BART


DIZON, they begot three (3) children namely, Christopher Dizon, Daniel
Dizon and Juan Miguel Dizon. Photocopy of their Birth Certificates are
hereto attached and marked as Annexes “B-1 to B-3”, and made an
integral part hereof;

43. That Bart Dizon, is a businessman and was insured (Accidental Death,
with SUNLIFE ASSURANCE CO. OF CANADA, a foreign corporation
with office address at 7th Floor, Interbank building Paseo de Roxas St.,
Makati Metro Manila, under Policy Insurance No. 9146393. Photocopy of
the Insurance Policy is hereto attached and marked as Annex “C” and
made an integral part hereof;

44.That in the Life Insurance Policy of Bart Dizon, was designated


Christopher Dizon his eldest son as his primary beneficiary, and other
children where whom the foregoing petition for guardianship is sought for;
45. That on Febuary 5, 2005 Bart Dizon, was driving a Van owned by him
with Plate No. CTP 845, from Mulanay, Quezon to Lucena City, and while
passing along the National Road of Brgy. Burgos, Padre Burgos Quezon,
the vehicle he was driving lost its break and bumped a concrete wall of the
house of Mr. Francisco Villena. He was rushed to the nearest hospital
which is Mt. Carmel Diocesan General Hospital Lucena City, for medical
treatment together with the passengers of the said Van.

46.That, however, when Bart Dizon was brought to the hospital, he was
declared Dead on Arrival due to the Serious Physical Injuries he sustained.
Photocopy of Certificate of Death is hereto attached and marked as Annex
“D”, and made an integral part hereof;

47. That due to the accident causing the death of Bart Dizon, the petitioner is
instituting this present petition for the purpose of making a claim to the
insurance proceeds of her late husband amounting to FIVE HUNDRED
THOUSAND PESOS (P500,000), from SUNLIFE ASSURANCE CO.
OF CANADA. Photocopy of Claimant ‘s Statement (Death Benefit) Form
B, is hereto attached and marked as Annex “E” and made an integral part
hereof;

48.That in lieu of the above-cited reasons, it is necessary and convenient that


LISA SIMPSON-DIZON, guardian for her minor children Christopher
Dizon, named as primary beneficiary, Daniel Dizon and Juan Miguel
Dizon, be appointed as LEGAL GUARDIAN, and for the purpose of
claiming the insurance proceeds and other benefits that may hereinafter
due him.

PRAYER
WHEREFORE, premise considered, it is respectfully prayed after due
notice and hearing, petitioner be appointed as LEGAL GUARDIAN of her minor
children to claim the insurance proceeds and other benefits that may due him
and that corresponding Letters of Guardianship be issued in favor of LISA
SIMPSON-DIZON.
ATTY. JOSE REYES
Counsel for the Petitioner
Until December 31, 2012
PTR NO. 001/01-01-01/Lucena City
IBP NO. 002/02-02-02/Quezon Province
Roll No. 49606
VERIFICATION AND CERTIFICATION
AGAINST NON- FORUM SHOPPING

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF QUEZON )
MUNICIPALITY OF LUCBAN ) S.S.

I, LISA SIMPSON-DIZON, of legal age, widow, after being duly sworn


to in accordance with law, depose and says:

That I am the petitioner in the above-entitled case, that I have caused the
preparation of the preparation of the foregoing petition and understood the
contents thereof, and I hereby declare that all the allegations contained therein
are true and correct according to my knowledge and belief.

Furthermore, I hereby certify that I have not filed nor caused to be filed a
similar case involving the same issues in the Supreme Court, Court of Appeals or
any tribunal or agency, I shall inform the Court, tribunal or agency of such fact
within five (5) days thereof.

______________________
LISA SIMPSON-DIZON

SUBSCRIBED AND SWORN to before me this 31th day of March 2006


at Lucena City, affiant exhibiting to me her Community Tax Certificate No. 12345
issued on MARCH 1,2006 , at Tayabas, Quezon.

ATTY. JOSE REYES


Doc. No. 1 ; NOTARY PUBLIC
Page No. 2 ; Until December 31, 2012
Book No. 3 : PTR NO. 2721387/01-07-05/Lucena City
Series of 2012. IBP NO. 639868/02-01-05/Quezon Province
Roll No. 49606
REPUBLIC OF THE PHILIPPINES
FOURTH JUDICIAL REGION
REGIONAL TRIAL COURT
Branch 12 Lucena City

IN THE MATTER OF THE:


PETITION TO ALLOWANCE OF
THE WILL OF ESTANISLAO
TORRES SPECIAL PROCEEDING NO. 67891
Testator,
FOR: PROBATE OF WILL

ENRIQUE TORRES (Testator)


Petitioner,

x---------------------------------------------x

PETITION FOR PROBATE OF A NOTARIAL WILL

COME NOW the petitioner by the undersigned attorney, and unto this
Honorable Court, respectfully avers:

 That petitioner, ENRIQUE TORRES, Filipino, of legal age,


married, native of Lucban, Quezon, now actually residing at No. 80 Don
Vedasto Cadeliña, Lucban Quezon, Philippines.

 That the petitioner , having all the legal qualifications and being of
sound and disposing mind and memory, and not acting under undue
influence, violence, fraud, or intimidation of whatever kind, did execute
such will in accordance with the requirements and formalities of law--- a
copy of which is attached as Annex “A” and made an integral part of this
petition.

 Petitioner by these presents declare this to be the Last Will and


Testament, which have caused to be written in English, the language which
is known, hereby declare, that: (ATTACHED IN ANNEX “A”)

49. I desire that my remains be buried according to the rites of


the Roman Catholic Church and with dignity suitable to my
circumstances;

50. The testator is a World War II Veteran and a member of the


Department of Veterans Affairs and Philippine
Veterans Affairs, with Veteran Assistance File Number C
30-325-894 and Claim No. MCO-90-008067, respectively.

51.I am entitled to Disability/Pension/ Death Benefits and/or other


claims from the above-mentioned Offices/Agencies;

52. I hereby give and bequeath to my adopted son ANGELO


MIGUEL TORRES, a sum of ONE HUNDRED
THOUSAND PESOS (P100,000.00), Philippine
Currency, to be derived from the Disability/Pension/ Death
Benefits and/or other claims;

53. I further give and bequeath to my daughters, namely,


ANGELINA S. TORRES and BELLA T. PAEZ, who both
have been my constant companion and nurse in my illness,
the Disability/Pension/ Death Benefits and/or other claims,
after full settlement of all expenses, necessary and incidental,
that may incurred after my death, such as wake, vigil, mass,
interment or funeral expenses and alike, also to be derived
from the said benefits and/or claims; and after the delivery of
the ONE HUNDRED THOUSAND PESOS (P
100,000.00), Philippine Currency, to my adopted son
ANGELO MIGUEL S. TORRES;

54. For the purpose of rendering this Last Will and Testament
effective thru the proper proceeding in court, I hereby
designate and constitute BELLA T. PAEZ, to be the
executor of my Last Will and Testament, and in her default or
incapacity to act, I hereby name her sister as her substitute
ANGELINA S. TORRES;

55. I hereby direct that the executor named herein or her lawful
substitute should serve without bond;

56. I hereby revoke any and all my other wills, codicils, or


testamentary dispositions heretofore executed, signed, or
published, or alleged to have been executed, signed or
published, by me.

4. That the petitioner disposes by his will properties real and personal,
approximately ONE MILLION PESOS (P1,000,000.00).
5. That there are 5 copies, duly signed and executed, of this will and
said copies are in the custody of the following persons: ANGELO
MIGUEL TORRES, BELLA T. PAEZ and ANGELINA S. TORRES.

WHEREFORE, it is respectfully prayed that, after due hearing, this will of


petitioner be approved and allowed.

IN WITNESS WHEREOF, I have hereunto set my hand this 9 th day of


March 2006, at Lucban, Quezon, Philippines.

ATTESTATION CLAUSE

We, the undersigned attesting witnesses, whose residences are stated


opposite our respective names, do hereby certify: That the testator, ENRIQUE
TORRES, has published unto us the foregoing will, consisting of three (3) pages
numbered correlatively on the bottom part of each page, as his Last Will and
Testament and has signed the same on each and every page thereof, on the left
margin, in our joint presence and we, in turn, at his request have witnessed and
signed the same on every page thereof, on the left margin, in the presence of the
testator and in the presence of each and all of us.

____________________________
CLAIRE F. MENDEZ No. 22 Maderal St., Lucban, Quezon
Witness

____________________________
IMELDA C. BALA Patricio St., Fabie Heights, Lucban, Quezon
Witness

_____________________________
IRENE A. MIRANDA No. 39 Rizal Ave., Lucban, Quezon
Witness
REPUBLIC OF THE PHILIPPINES
PROVINCE OF QUEZON }
MUNICIPALITY OF LUCBAN } S.S.

BEFORE ME, A Notary Public for and in the Province of Quezon,


Philippines, this 9th day of March 2006, at Lucban, Quezon, parties, personally
appeared:

The testator, ENRIQUE TORRES, with CTC No.19241271 issued at


Lucban Quezon on March 2, 2006;
Witness, CLAIRE F. MENDEZ, with CTC No. 08713776 issued at
Lucban, Quezon on January 4, 2006;
Witness, IMELDA C. BALA, with CTC No. 08713773 issued at Lucban,
Quezon on January 4, 2006;
Witness, IRENE A. MIRANDA, with CTC No. 16133068 issued at
Lucban, Quezon on January 4, 2006.

All know to me to be the same persons who signed the foregoing Will, the
first as testator and the last three as instrumental witnesses, and they respectively
acknowledged to me that they signed the same as their own free act and deed.

This Will consists of three (3) pages, including the page on which this
acknowledgment is written, and has been signed on the left margin of each and
every page thereof by the testator and his witnesses, and sealed with my notarial
seal.
IN WITNESS WHEREOF, I have hereunto set my hand the day, year and
place above-written.

Doc. No. 1 ;
Page No. 2 ;
Book No. III ;
Series of 2012.
VERIFICATION AND CERTIFICATION
AGAINST NON- FORUM SHOPPING

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF QUEZON )
MUNICIPALITY OF LUCBAN ) S.S.

I, ENRIQUE TORRES, of legal age, executor of the Last Will and


Testament of ESTANISLAO TORRES, after being duly sworn to in accordance
with law, depose and says:

That I am the petitioner in the above-entitled case, that I have caused the
preparation of the preparation of the foregoing petition and understood the
contents thereof, and I hereby declare that all the allegations contained therein
are true and correct according to my knowledge and belief.

Furthermore, I hereby certify that I have not filed nor caused to be filed a
similar case involving the same issues in the Supreme Court, Court of Appeals or
any tribunal or agency, I shall inform the Court, tribunal or agency of such fact
within five (5) days thereof.

______________________
ENRIQUE TORRES

SUBSCRIBED AND SWORN to before me this 31th day of March 2006


at Lucena City, affiant exhibiting to me his Community Tax Certificate No. 12345
issued on MARCH 9,2006 , at Tayabas, Quezon.

ATTY. JOSE GUZMAN


Doc. No. 1 ; NOTARY PUBLIC
Page No. 2 ; Until December 31, 2012
Book No. 3 : PTR NO. 2721387/01-07-05/Lucena City
Series of 2012. IBP NO. 639868/02-01-05/Quezon Province
Roll No. 49606
REPUBLIC OF THE PHILIPPINES
FOURTH JUDICIAL REGION
REGIONAL TRIAL COURT
Branch 55
Lucena City
IN THE MATTER OF :
THE ADOPTION OF MINOR,
PEDRO SANTOS

SPECIAL PROCEEDING NO. 56789


JUAN DELA CRUZ and FOR: PETITION FOR ADOPTION
MARIA DELA CRUZ,

Petitioners,

x--------------------------------------------x

PETITION FOR ADOPTION OF MINOR

COME NOW the petitioners by the undersigned attorney, and unto this
Honorable Court, respectfully avers:

1. That the petitioners are husband and wife, both of age, and residents of
12 A. J.V. Eleazar St., Lucban,Quezon;

2. That they have no legitimate children or descendants and hereby desire


to jointly adopt a minor, named PEDRO REYES, of SEVEN (7) years of age,
legitimate child of PAUL REYES and PAULA REYES;

3. That the father of said minor is now dead, and only her mother, named
HONORARIA REYES, is alive;

4. That said mother, HONORARIA REYES, is not insane, nor intemperate,


nor has she abandoned such minor, and with full knowledge of petitioners’
intention hereby expressly gives her written consent to the adoption, as
evidenced by Annex “A”, hereto attached and made integral part of this petition;

5. That the petitioners are qualified to adopt the said minor, and will be
able financially and morally, to bring up and educate said minor, properly and
adequately.

WHEREFORE, it is respectfully prayed, that upon due notice and hearing,


judgment be entered adjudging that the minor child PEDRO REYES be freed
from all legal obligations of obedience and maintenance with respect to her
natural patents, and that she be declared to all legal intents and purposes, the
child of the herein petitioner, and that her surname be changed to that of the
petitioners.

IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of June


2007, at Lucena City.

ATTY. JUAN MIGUELITO GUZMAN


Counsel for the Petitioner
Room 6-8, St. Mary’s Business Center,
Perez Street, Lucena City
IBP No. 672377/ 01-05-07/Quezon Province
Roll No. 49606

Copy Furnished:

THE PROVINCIAL PROSECUTOR


RTC Bldg., Lucena City

VERIFICATION AND CERTIFICATION


AGAINST NON-FORUM SHOPPING

I, MARIA DELA CRUZ, of legal age, widow and a resident of 12 A. J.V.


Eleazar St., Lucban,Quezon, after being duly sworn to in accordance with law,
depose and says;

57. That I am the petitioner in the instant petition;

58. That I caused the preparation of the foregoing petition and I read the
allegations therein and certify that the same are true and correct of my
personal knowledge;

59. I further certify that I have not commenced any other action involving
the same issues before the Supreme Court, Court of Appeals or any
tribunal or agency; to the best of my knowledge no such action is
pending before Supreme Court, Court of Appeals or any tribunal or
agency; and

60.That in the event that that any action involving the same should be
known, I hereby bind myself to report to the same within five (5) days
(5) days from knowledge thereof to this Honorable Court.
IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of June
2007, at Lucena City.

_____________________
MARIA DELA CRUZ

SUBSCRIBED AND SWORN to before me this 6th day of June 2007, at


Lucena City, affiant, exhibiting to me her Community Tax Certificate No. 12345,
issued on MARCH 1, 2007 at LUCBAN QUEZON.

Doc. No. 1 ;
Page NO. 2 ;
Book No. 3 ;
Series of 2012.
REPUBLIC OF THE PHILIPPINES
FOURTH JUDICIAL REGION
REGIONAL TRIAL COURT
Branch 20
Lucena City

RE: IN THE MATTER OF CORRECTION/


CHANGE OF GENDER FROM MALE TO
FEMALE, AND NAME BENY RACELIS
PALENZUELA TO BENNY RACELIS
PALENZUELA IN THE CIVIL REGISTRY
OF LUCBAN, QUEZON

SP PROC. NO. 123456


FOR: PETITION FOR CHANGE OF NAME
AND CORRECTION OF GENDER

BENNY RACELIS PALENZUELA,


Petitioner.

61. versus -

THE LOCAL CIVIL REGISTRAR OF


LUCBAN, QUEZON,
Respondent.

PETITION FOR CHANGE OF NAME


AND CORRECTION OF ENTRY(GENDER)

COMES NOW, the petitioner, through the undersigned counsel, and unto
this Honorable Court, most respectfully avers:

 That the petitioner is of legal age, FEMALE, single, and a resident of


4746 Peralta St., V. Mapa Sta. Mesa, Manila ;

 That she has been a bona fide resident of Municipality of Lucban,


Province of Quezon since the year 1956, for at least twenty (20) years
prior to the date of the filing of this petition;

 That her given name is BENNY RACELIS PALENZUELA, and for


all legal intent and purposes, she has been using said name in all
documents whether public or private written instrument including her
scholastic records; (Copies of her scholastic records and other
pertinent documents, are hereto attached and marked as Annexes “A”
to “G”);
 That however, in her Certificate of Live Birth, particularly in entry No.
3 issued by the Local Civil Registry of Lucban, Quezon, there appears
an entry which reads BENY RACELIS PALENZUELA, which
purports to be the name of the petitioner. Certified True Copy of the
Certificate of Live Birth, issued by the Office of the Local Civil Registry
of Lucban, Quezon, is hereto attached and marked as Annex “H”;

 That , likewise, in entry No. 4, there appears an entry that reads MALE
which purports to be the gender of the petitioner;

 That in truth and in fact, her name is BENNY RACELIS


PALENZUELA and her gender is FEMALE;

 That from the aforementioned premises, it is but proper and lawful for
the petitioner to seek the intervention of this Honorable Court to order
the necessary corrections in the Certificate of Live Birth of herein
petitioner for convenience and avoidance of future confusion ;

WHEREFORE, 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 name of BENY RACELIS PALENZUELA
be changed/corrected to BENNY RACELIS PALENZUELA, and that her
gender from MALE, as appearing in her Certificate of Live Birth
changed/corrected to FEMALE. Petitioner further prays for such other relief just
and equitable under the premises.

Respectfully Submitted.

Lucena City, this 20th day of June 2006.

ATTY. JOSE REYES


Counsel for the Petitioner
St. Mary’s Business Center Rm3,
Perez St., Lucena City
PTR NO. 00779748/01-05-12/Lucena City
IBP NO. 639498/12-28-05/Quezon Province
Roll no.49606
VERIFICATION AND CERTIFICATION
AGAINST NON- FORUM SHOPPING

I, BENNY RACELIS PALENZUELA, of legal age, single, after being


duly sworn to in accordance with law, depose and says:

That I am the petitioner in the above-entitled case, that I have caused the
preparation of the preparation of the foregoing petition and understood the
contents thereof, and I hereby declare that all the allegations contained therein
are true and correct according to my knowledge and belief.

Furthermore, I hereby certify that I have not filed nor caused to be filed a
similar case involving the same issues in the Supreme Court, Court of Appeals or
any tribunal or agency, I shall inform the Court, tribunal or agency of such fact
within five (5) days thereof.

______________________
BENNY RACELIS PALENZUELA
Affiant

SUBSCRIBED AND SWORN to before me this 20th day of June 2006,


at Lucena City, affiant exhibited to me her Community Tax Certificate No.
22730249 issued on March 3, 2006, at Lucban, Quezon.

ATTY. JOSE ANTONIO D. APARTE


Doc. No. _________ ; NOTARY PUBLIC
Page No. _________; Until December 31, 2012
Book No. _________: PTR NO. 0079748/01-05-06/Lucena City
Series of 2012. IBP NO. 639498/12-28-05/Quezon Province
Roll No. 49606
NOTICE

THE CLERK OF COURT


RTC-BRANCH 55, Lucena City

GREETINGS!

Please submit the foregoing Petition upon receipt hereof for the kind
consideration and resolution of this Honorable Court.

ATTY. JOSE REYES


Counsel for the Petitioner

Copy Furnished:

The Local Civil Registrar of Lucban, Quezon


Municipal Bldg., Lucban Quezon

The Solicitor General


Amorsolo St., Makati City

The Provincial Prosecutor


Quezon Province
Lucena City

The Civil Registrar-General


Manila
EXPLANATION

Copies of the Petition with its annexes here furnished to the Office of the
Solicitor General, Provincial Prosecutor, Local Civil Registrar of Lucban, Quezon,
Civil Registrar-General, by registered mail due to lack of manpower and distance
separating the parties.

ATTY. JOSE ANTONIO D. APARTE


REPUBLIC OF THE PHILIPPINES
LOCAL CIVIL REGISTRY OFFICE
METRO MANILA
Branch 12
Quezon City

Republic of the Philippines )


City of Manila ) SS

IN THE MATTER OF PETITION FOR SP PROC. NO. 56789


CORRECTION OF CLERICAL ERROR, FOR: PETITION FOR
IN FAVOR OF JUAN DELA CRUZ, CORRECTION OF
ENTRY
IN THE CERTIFICATE OF LIVE BIRTH

PETITION FOR CORRECTION OF CLERICAL ERROR


IN THE CERTIFICATE OF LIVE BIRTH

I, JUAN DELA CRUZ, of legal age, Filipino, married to Maria Santos-Dela


Cruz with residence and postal address at 123, Biglang Awa St., Diliman, Quezon City,
after having been duly sworn to in accordance with law, hereby declare that:

 I am the petitioner seeking correction of the clerical error in :


[ X ] a. my Certificate of Live Birth
[ ] b. the Certificate of Live Birth of ________________________;

 I was born on JANUARY 1, 1957 at Manila City, Philippines;

 The birth was recorded under registry number 123;

 The clerical error(s) to be corrected is (are):


Item No. Description From To
Name of Child Baby Boy Juan

 That the discrepancy made in my Certificate of Live Birth was merely


typographical of the person committed during registration;

 I submit the following documents to support this petition;


62. My NSO certified photocopy of my Certificate of Live Birth showing
erroneously my FIRST NAME as “Baby Boy”;
63. My NSO certified photocopy of Marriage Contract showing my FIRST
NAME as “Juan”;
64. My eldest child’s certified photocopy of his Certificate of Live Birth
(John Dela Cruz) showing my FIRST NAME as “Juan”;
65. My 2nd and youngest child’s NSO certified photocopy of his Certificate
of Live Birth (Peter Dela Cruz) showing my FIRST NAME as “Juan”;
66. Photocopy of my most important government-issued IDs such as my
latest valid Philippine Passport, my latest valid Philippine Driver’s
License card and my employee’s ID (University of the Philippines) all
showing consistently my FIRST NAME as “Juan”;
 I have not filed any similar petition and that, to the best of my knowledge,
no other similar petition is pending with any LCRO or any Court of Philippine
Consulate;

 I am filing this petition at the LCRO of Manila City, in accordance with


R.A. No. 9048 and its implementing rules and regulations.

JUAN DELA CRUZ


Signature over printed name of petitioner

VERIFICATION

I, JUAN DELA CRUZ, the petitioner, hereby certify that the allegations herein
are true and correct to the best of my knowledge and belief.

JUAN DELA CRUZ


Signature over printed name of petitioner

SUBSCRIBED AND SWORN to before me this March 8, 2010 in Quezon City,


petitioner exhibiting his Philippine Passport issued on October 13, 2010 and valid up to
October 12, 2013 issued by DFA Manila.

Doc. No. 1 ;
Page. No. 2 ;
Book. No. 3 ;
Series of 2010.

------------------------------------------------------------------------------------------------------------
For C/MCR use only
ACTION TAKEN BY THE C/MCR

GRANTED DENIED (provide the basis for


denial)

________________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Date : _____________________ _______________________


Civil Registrar
-----------------------------------------------------------------------------------
For CRG use only

ACTION TAKEN BY THE CRG

AFFIRMED IMPUGNED
_______________________________________________________________________
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Date : _____________________ ________________________


Civil Registrar General
------------------------------------------------------------------------------------------------------------

Payment of filing fee (Please attach copy of the official receipt.)

O.R. No. : _________________


Amount Paid : _________________
Date Paid : _________________
\petition for correction of first name ra 9048
REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
NATIONAL CAPITAL JUDICIAL REGION
MAKATI CITY

IN RE: PETITION FOR COMMISSION


AS NOTARY PUBLIC IN THE
CITY OF MAKATI

JUAN DELA CRUZ


Petitioner
x-----------------------------------------------------------x

PETITION

Petitioner, JUAN DELA CRUZ, (hereinafter “Petitioner”) respectfully


states:

1. Petitioner is of legal age, Filipino and holding office 1233 FGU


TOWER, AYALA AVENUE, MAKATI CITY.

2. Petitioner is a member of the Philippine Bar having been admitted


to the practice of law on 1999, 2010 as evidenced by a photocopy of his Certificate
of Membership attached hereto and made an integral part hereof as Annex “A”.

3. Petitioner has not been accused of any crime involving moral


turpitude before any court or tribunal in the Philippines.

4. Petitioner is not a member of any subversive association or any


association advocating to overthrow the existing government.

5. Petitioner is not a government employee nor has he applied for the


same commission in any other jurisdiction.

6. Petitioner has paid his membership fee with the Integrated Bar of
the Philippines as per IBP Official Receipt No. 12345 dated January 1, 2010, a
photocopy of which is attached hereto as Annex “B”. He has also paid the
Professional Tax Receipt due his as evidenced by PTR No. 123456 dated January
1, 2010 a photocopy of which is also attached herewith as Annex “C”.
7. The true impression of Petitioner’s notarial seal is attached to this
Petition together with the three specimens of his signature as Annexes “D” and
“E” respectively.

PRAYER

WHEREFORE, petitioner respectfully prays that he be commissioned as


Notary Public for the City of Makati.

Respectfully submitted.

Makati City, August 3, 2010.

NAME
PTR No. 12345-03-04/7-28-10/Makati
City
IBP No. 12345-09/4-28-10/Quezon City

REPUBLIC OF THE PHILIPPINES)


City of Makati ) S.S.

VERIFICATION

I, JUAN DELA CRUZ, of legal age with address at 1234 AYALA AVENUE,
MAKATI CITY, depose and state:

1. I am the Petitioner in the above Petition.

2. I have caused the preparation of the foregoing Petition.

3. I certify that I have read and understood the contents thereof and
verify that the facts stated therein are true and correct based on my
personal knowledge and authentic records.

Affiant further sayeth naught.

JUAN DELA CRUZ


SUBSCRIBED AND SWORN to before me this ____ day of August 2010,
affiant exhibiting to me his Driver’s License No. __________ issued by the
Land Transportation Office of Quezon City and which will expire on ______,
2011.

Doc. No.
Page No.
Book No.
Series of 2010.

You might also like