Republic of the Philippines

REGIONAL TRIAL COURT

5th Judicial Region
FAMILY COURT
Sorsogon, Sorsogon

Georgina Y. Balonzo,
Petitioner,
versus
Civil Case No. 123456
For: Petition for Legal
Separation
Jomar T. Balonzo,
Respondent.
/--------------------------------------------------------/

PETITION FOR LEGAL SEPARATION

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

PARTIES
1. Petitioner Georgina Y. Balonzo (Ina for brevity) is of legal age,
Filipino citizen, with capacity to sue and be sued, and a resident of
Binisitahan, Magallanes, Sorsogon, where notices, orders,
resolutions and other legal processes may be served upon her or
through her counsel of record;
2. Jomar T. Balonzo (Mar for brevity) is of legal age, Filipino citizen
and a resident of Gardenvilee Subdivision, Bulan Sorsogon, where
notices, orders, resolutions and other legal processes may be
served upon her, also with capacity to sue and be sued;
3. Ina and Mar are husband and wife, having been legally married
on December 28, 2010 at Sorsogon Municipal Hall, a copy of the
Certificate of Marriage is hereto attached as Annex “A” and made
part hereof;

NATURE OF THE PETITION AND JURISDICTIONAL FACTS

4. This is an action for legal separation between Petitioner and

Respondent on the ground of repeated physical abuse of the
respondent under Article 55 (1) of the Family Code, which falls
under the exclusive original jurisdiction of the Family Court. The
same action shall be filed in the Family Court of the province or
city where the petitioner or the respondent has been residing for at
least six (6) months prior to the date of filing. In this case, the
Honorable Regional Trial Court of Sorsogon City Branch 12
designated as the Family Court, therefore having jurisdiction over
the present action;

5. The action is based on the Family Code Provision Article 55

which states that:
(1) repeated physical violence or grossly abusive
conduct directed against the petitioner, a common child,
or a child of the petitioner;

6. Petitioner is submitting the required Certification and Sketch,

duly notarized, of her residence at Unit 12 Lady Abriana
Townhouses, Magallanes, Sorsogon, attached herewith are the
following: (1) sworn Certification of Residency issued by the
barangay; (2) sworn certification of the counsel as to the
verification of petitioner’s residency; (3) Petitioner’s Driver’s
License ; and (4) Sketch Map of the residence of the petitioner
marked as Annexes “B-1”, “B-2” “B-3”, and “B-4” respectively;

FACTS OF THE CASE

7. Petitioner Georgina Y. Balonzo (Ina for brevity) met Respondent
Jomar T. Balonzo (Mar for brevity) when they were in second year
college and married after graduating from B.S Architecture on
June 2, 2016.
8. That the spouses lived in blissful harmony at Lady Iza
Mountainview Sorsogon, a property inherited by Ina from her
parents, which constituted as their family home, attached herewith
as Annex B.
9. That during the first year of their marriage, Mar turned out to be
a violent brute that would hit and utter profanities at Ina everytime
they had a disagreement.
10. On December 25, 2018, Ina gave birth to the couple’s only
child Solomon Y. Balonzo.
11. That starting from January- February 2019, Mar would spend
weeks away from the family home on business trips but charge the
expenses at the couple’s shared joint account.
12. That on August 1, 2019, Ina found out that Mar’s secretary
would accompany him to this business trips including trips to
numerous bars, the bills would go as high as one hundred thirty
thousand per trip, when she confronted him Mar beat her up
resulting to multiple bruises and a broken arm. Attached herewith
is Annex “D”.
 PRAYER
WHEREFORE, in view of the foregoing, petitioner respectfully
prays that:
1.After due hearing, a decree of legal separation between
the petitioner and respondent be issued by this Honorable
Court;
2.The absolute community of property relations be ordered
dissolved and liquidated. Depriving the respondent of her
share in the profits of the absolute community;

Such other relief just and equitable under the circumstances be

granted.

IN WITNESS WHEREOF, I have set hereunto my hand this 21th

day of September 2021, Makati City, Philippines.

ATTY. LIZA MARIE DEE SIA

Counsel for Petitioner
IBP No. 54321; 01-05-21; Sorsogon
PTR No. 678910; 01-05-21; Sorsogon
Attorney’s Roll No. 123456
MCLE VI-0001234/X-XX-XX
SUBSCRIBED AND SWORN to before me this 21st day of
Septemeber 2021, Sorsogon City, Philippines.

ATTY. PATRICIA DE LOS REYES

NOTARY PUBLIC
IBP No. 5555; 01-03-21; Sorsogon
PTR No. 1234567; 01-03-21; Sorsogon
Attorney’s Roll No. 1111111
MCLE VI-0001234/X-XX-XX
Doc. No. 04;
Page No. 02;
Book No. 02;
Series of 2021

Copy Furnished:

JOMAR T. BALONZO
Gardenvilee Subdivision,
Bulan Sorsogon

OFFICE OF THE SOLICITOR GENERAL

134 Amorsolo St., Legaspi Village,
Makati City

OFFICE OF THE CITY PROSECUTOR

City Hall, Magsaysay Street
(056) 211 1110

EXPLANATION OF SERVICE BY REGISTERED MAIL

The undersigned respectfully states that a copy of this

Petition was served upon the other parties by Registered Mail with
return card by reason of far distance and lack of sufficient
messengerial services which renders personal service hereof
impracticable. This explanation is made pursuant to Rule 13 of the
Rules of Court.

LIZA MARIE DEE SIA

 VERIFICATION AND CERTIFICATION OF
NON-FORUM SHOPPING
REPUBLIC OF THE PHILIPPINES)
CITY OF SORSOGON ) SS.

I, Georgina Y. Balonzo, after having been duly sowrn in

accordance with the law, sposes and states that:
1. I am the petitioner in this case;
2. I have caused the preparation of the foregoing
action;
3. The allegations in the said initiatory pleading are
true and correct based on my personal knowledge and
on authentic documents;
4. The pleading is not filed to harass, cause
unnecessary delay, or needlessly increase the cost of
litigation;
5. The factual allegations therein have evidentiary
support or, if specifically so identified, will likewise
have evidentiary support after a reasonable
opportunity for discovery;
6. I hereby certify that have not commenced any any
action or filed any claim involving the same issues in
any court, tribunal or quasi- judicial agency and, to the
best of my knowledge, no such other action or claim is
pending therein, and if there is such other pending
action or claim, a complete statement of the present
status thereof;
7. If I should thereafter learn that the same or similar
action or claim has been filed or is pending, I shall
 report that fact within five (5) calendar days therefrom
to the court wherein my aforesaid initiatory pleading
has been filed; and
8. I executed this verification and certification to attest
to the truth of the foregoing facts and in accordance
with A.M. No. 19-10-20 of the Honorable Supreme
Court.

IN WITNESS WHEREOF, I have hereunto set my hand this 17th

day of September 2021, at Makati City, Philippines.

Georgina Y. Balonzo
AFFIANT

SUBSCRIBED AND SWORN to before me this 21st day of

Septemeber 2021, Sorsogon City, Philippines.

ATTY. PATRICIA DE LOS REYES

NOTARY PUBLIC
IBP No. 5555; 01-03-21; Sorsogon
PTR No. 1234567; 01-03-21; Sorsogon
Attorney’s Roll No. 1111111
MCLE VI-0001234/X-XX-XX

Doc. No. 04;

Page No. 02;
Book No. 02;
Series of 2021.
Annex a
 ANNEX B-1
REPUBLIC OF THE PHILIPPINES
Municipality of Magallanes
BARANGAY MAPAGOD
Tel No. XXX-XXXX

OFFICE OF THE BARANGAY CAPTAIN

CERTIFICATE OF RESIDENCY

TO WHOM IT MAY CONCERN:

This is to certify that Ysabelle Acdal-Demesa, of legal age, married,

Filipino citizen whose specimen signature appears below, is a PERMANENT
RESIDENT of Barangay Mapagod, Magallanes, Sorsogon.

Based on the records of this office, he has been residing at Barangay

Mapagod since February 2019.

This CERTIFICATION is being issued upon the request of the above named
person for whatever legal purposes it may serve.

Issued this 20th day of September 2021 at Barangay Mapagod, Magallanes,

Sorsogon, Philippines.

Eric Tordillos
Punong Barangay
 ANNEX B-2
CERTIFICATION OF RESIDENCY
REPUBLIC OF THE PHILIPPINES)
CITY OF SORSOGON ) SS.

I, Liza Marie Dee Sia, after having been duly sworn in accordance with
law, deposes and states that:
1. I am the counsel of Ysabelle Acdal-Demesa, petitioner in the civil
case for annulment of marriage to be filed before the Family Court of
Sorsogon City;
2. On 01 July 2021, I personally went to the developer of Lady Abriana
Townhouses to personally verify if the petitioner is a resident of Unit 13,
Lady Abriana Townhouses, Mapagod, Magallanes, Sorsogon;
3. Upon verification with the aforementioned offices, the petitioner is a
resident of said address since 2019.
4. I executed this certification to attest to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 21st day of

September 2021, at Sorsogon City, Philippines.

ATTY. LIZA MARIE DEE SIA

Counsel for Petitioner
IBP No. 54321; 01-05-21; Sorsogon
PTR No. 678910; 01-05-21; Sorsogon
Attorney’s Roll No. 123456
MCLE VI-0001234/X-XX-XX

SUBSCRIBED AND SWORN to before me this 21st day of Septemeber

2021, Sorsogon City, Philippines.
ATTY. PATRICIA DE LOS REYES
NOTARY PUBLIC
IBP No. 5555; 01-03-21; Sorsogon
PTR No. 1234567; 01-03-21; Sorsogon
Attorney’s Roll No. 1111111
MCLE VI-0001234/X-XX-XX
Doc. No. 04;
Page No. 02;
Book No. 02;
Series of 2021
ANNEX B-3
ANNEX B-4
 ANNEX C
Republic of the Philippines
National Police Commission
Philippine National Police
SORSOGON POLICE STATION
Sorsogon City, Sorsogon

SPOT REPORT

August 01, 2019

AN EXCERPT FROM THE DAILY RECORD OF EVENTS OF LEGAZPI
POLICE STATION, WOMEN AND CHILDREN PROTECTION DESK DATED
JUNE 25, 2011 ENTRY NO. 0130, 0131 AND 00132 AS ENTERED UNTO THE
WCPD BLOTTER BOOK BY PO3 TERRY DIAZ.

TIME: COMPLAINT : PARTICULAR

(6:30 PM): Record: Entry No. 0130- A Phone Call Received by SPO1 KIT TOPE,
who received a call from concerned citizen who identified herself as Georgina
informing that there was a physical abuse incident transpired at Sorsogon City.

(7:00 PM): Departure: Entry No.0131- In connection with the preceding entry,
PNP team led by SPO1 AYONIKA AGUILA together with SPO1 SARAH AND
PO2 ARLENE APELO WCPD PNCO left this station and proceeded to the place
of incident to verify the veracity of said report and to conduct investigation.

Initial Investigation disclosed that on or about 5:30 PM of August 01, 2019,

the spouses had an argument and while the victim was drinking water, the
accused smashed her face in the kitchen counter, twisted her arm until it
pooed and repeatedly bashed her face and arm causing serious physical
injuries.

Following items recovered from the crime scene to wit; handkerchief. Victim
was also referred to METROHEALTH for medical examination.
Note: This copy was being reproduced from the original for whatever legal
purpose it may serve

Prepared by:

PO3 PETER HABANGULAT

WCPD - PNCO

JOSEPH ALUBUDBURUN
LUBID
Police
Superintendent
Chief of Police