REPUBLIC OF THE PHILIPPINES

NATIONAL CAPITAL JUDICIAL REGION

REGIONAL TRIAL COURT
PASAY CITY

IN RE: ABC DEF

PETITION FOR CHANGE OF NAME

The petitioner, ABC DEF, hereby states:

1. That the Petitioner is over the age of twenty-one (21) years and is a resident of #1
Lourdes St., Pasay City, Philippines.

2. Petitioner wishes to change his/her name because:

(a.) The petitioner finds the first name or nickname to be ridiculous, tainted with
dishonor or extremely difficult to write or pronounce;
(b.)The new first name or nickname has been habitually and continuously used by
the petitioner and he has been publicly known by that first name or nickname
in the community;
(c.) The change will avoid confusion.

3. Petitioner states and affirms that this request for a name change is not for the purpose
of fraud, of violating any law, and is not/or will not, be detrimental to the interest of any
other party.

4. The petitioner, by his/her own affidavit, submits to the court that upon first being duly
sworn under oath before a Notary Public, all relevant facts as to why he desires a name
change have been revealed herein.

Therefore, he would like to be known henceforth as JKL DEF.

WHEREFORE, petitioner requests that this court allow his name to be legally changed from
ABC DEF to JKL DEF, and for this Court to order such a change in accordance with the laws of
the Philippines.

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

Republic of the Philippines

(City of Pasay ) S.S.

I, ABC DEF, of legal age, after having been duly sworn in accordance with law, depose and state
that:
1. I am a petitioner in the above-stated case;

2. I have read the contents thereof and the facts stated therein are true and correct of my personal
knowledge and/or on the basis of copies of documents and records in my possession;

3. I have not commenced any other action or proceeding involving the same issues in the
Supreme Court, the Court of Appeals, or any other tribunal or agency;

4. To the best of my knowledge and belief, no such action or proceeding is pending in the
Supreme Court, the Court of Appeals, or any other tribunal or agency;

5. If I should thereafter learn that a similar action or proceeding has been filed or is pending
before the Supreme Court, the Court of Appeals, or any other tribunal or agency, I undertake to
report that fact within five (5) days therefrom to this Honorable Court.

Pasay City, Philippines, November 21, 2020

__________________
ABC DEF

SUBSCRIBED AND SWORN to before me this 21 st day of November 2020,

Philippines affiant exhibiting to me her Passport No. 123456 issued in DFA Manila 2019.

Doc. No.1 XYZ LMN

Page No.1 NOTARY PUBLIC for Pasay
Book No.1 Commission Serial No.100
Series of 2020. Until December 31, 2020
Roll of Attorney 8888
IBP No. 8888

PTR No.8888