RA 9048 Form No. 4.

1 (LCRO)

REPUBLIC OF THE PHILIPPINES

CITY CIVIL REGISTRY OFFICE
Quezon City

Republic of the Philippines )

Quezon City ) SS Petition No.

PETITION FOR CHANGE OF FIRST NAME

I, SpongeBob A. Dela Cruz , of legal age, Filipino, and a resident of Blk 7 Lot 8 Toblerone St. Matcha
Subdivision, Marikina City after having been duly sworn to in accordance with law, hereby declare that:

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

a) my Certificate of Live Birth
2. I was born on April 1, 1998, at Fabella Hospital Sta. Cruz Manila, Philippines.

3. The birth was recorded under registry number 2948264628.

4. The first name to be changed is from Spongebob to Naruto.

5. The grounds for filing this petition are the following: (Ground selected should be explained/justified in a separate sheet of
paper to be attached to this form.)
a) The first name is tainted with dishonor;
b) The first name ridiculous;
c) The first name causes confusion:
6. I submit the following documents to support this petition: (Use additional sheets, if necessary.)
a) Affidavit of Two Disinterested Persons;
b) Joint Affidavit of Correction; and
c) Affidavit of No Pending Criminal Investigation or Prosecution.

7. I have not filed and similar petition and that, to the best of my knowledge, no longer similar petition is
pending with any CRO, Court or Philippine Consulate.
8. I am filing this petition at the CRO of Quezon City, Philippines.

9. in accordance with RA No. 9048 and its implementing rules and regulations.

SpongeBob A. Dela Cruz

Signature over printed name of petitioner
 VERIFICATION
I, SpongeBob A. Dela Cru, the petitioner, hereby certify that the allegations herein are true and correct to the best of
my knowledge and belief.

SpongeBob A. Dela Cruz

Signature over printed name of petitioner

SUBSCRIBED AND SWORN to before me this 6th day of May 2023 in the Quezon City, petitioner
exhibiting his Philippine Passport ID No. WRAF334232 issued at Pasay City on 17 November 2021, valid until 16
November 2031.

Doc. No. ________________;

Page. No. ________________ ;
Book No. ________________;
Series of 2023.