RA 9048 Form No. 1.

1 (LCRO)

Republic of the Philippines

Republic of the Philippines ) Petition No.: ________________
Cebu City ) SS

PETITION FOR CORRECTION OF CLERICAL ERROR IN THE

CERTIFICATE OF LIVE BIRTH
that:
1) I am the petitioner seeking the correction of entry in:
a) Certificate of Live Birth

2) My son was born on October 13, 2018 at Cebu City.

3) The birth was recorded under registry number __________.

4) The clerical error(s) to be corrected is/are (use additional sheets, if necessary)

5) The facts/reasons for filing this petition are the following: (use additional sheets if
necessary)
To correct the erroneous entry to coincide with my son’s other documents.

6) I submit the following documents to support this petition: (use additional sheets if
necessary)
a) Copy of Certificate of Live Birth
b) Copy of Voter’s ID of Mother

7) 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 Court of the Philippine Consulate.

8) I am filing this petition at the LCRO of Cebu City, Province of Cebu in accordance with
RA 9048 and its implementing rules and regulations
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Signature over Printed Name
VERIFICATION

I, ROSEMARIE HAGONOS FLARION, under oath, states:

1. I am the petitioner
2. I have caused the preparation of this petition
3. I have read the petition and all the facts stated here are true and correct to the best of my
personal knowledge and based on authentic records.

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 IN WITNESS WHEREOF, I have affixed my signature this 2 nd day of March, 2019 at
Cebu City, Cebu, Philippines.

Book No.: ____

Series of: ______

For C/MCR use only

ACTION TAKEN BY THE C/MCR

Granted Denied (Provide basis for denial)

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Date: ________ ________________________

City/Municipal Civil Registrar

For CRG use only

ACTION TAKEN BY THE CRG

Affirmed Impugned

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Date: ____________ _______________________

City Registrar General

OR No.: _________________________
Amount Paid: _____________________
Date Paid: ________________________