RA 9048 Form No. 1.

1 (LCRO)
(Revised 11 August 2001)

Republic of the Philippines

OFFICE OF THE CITY CIVIL REGISTRAR
Province of Cebu
Cebu City

Republic of the Philippines)

City of Cebu) Petition No.

PETITION FOR CORRECTION OF CLERICAL ERROR

IN THE CERTIFICATE OF LIVE BIRTH

I, ___________________, of legal age, Filipino, single and a resident of Cebu City after
having been duly sworn to in accordance with law, do hereby declare that:

1. I am the petitioner seeking the correction of clerical error in:

a) my Certificate of Live Birth

b) the Certificate of Live Birth of ______________

(complete name of owner)

Who is my client.
(relation of owner to the petitioner)

2. I/He/She was born on _______________ at Cebu City

(Date of Birth) (city/municipality)

Cebu , Philippines .
(Province) (Country)

3. The birth was recorded under registry number _____ .

4.
5. The clerical error/s to be corrected is/are: (Use additional sheets, if necessary)

  Item Number     Description         From               To

5. The facts/reason of filing this petition are the following: (Use additional sheets, if
necessary).
       
 6. I submit the following documents to support this petition: (Use additional sheets,
if necessary).
          1.   Special Power of Attorney
          2. Certificate of Birth (PSA Copy)
          3. Certificate of Birth (Local Copy)
          4. Baptismal Certificate
          5. COMELEC Voter’s record
          6. Birth Certificate of child__________
          7. Marriage Certificate ________
          8. Valid Government ID of Owner
          9. COMELEC Voter’s record

7. I have not filed similar petition and that to the best of my knowledge no other
similar petition is pending with any LCRO, Court or Philippines Consulate.

8. I am filing this petition at the Office of the City Civil Registrar, Cebu City.
(City/Municipality) (Province)

In accordance with R.A. 9048 and its implementing Rules and Regulations.

(Signature over printed name of petitioner)