REPUBLIC OF THE PHILIPPINES

SUPREME COURT OF THE PHILIPPINES

OFFICE OF THE BAR CONFIDANT
MANILA

IN RE: PETITION FOR CHANGE OF NAME

IN THE ROLL OF ATTORNEY,

No. _____________

From ____ to ______

Petitioner.

x---------------------------------------------------------------x

PETITION

COMES NOW, the undersigned Petitioner by herself unto this

Honorable Office, respectfully states:

1. That she took and passed the _______ Bar Examinations when
she was still single/unmarried;

2. That she was admitted to the Bar on _______, and signed the
roll (Roll No. _______) under the name of __________;

3. That on _________, she married ___________, (a PSA copy of her

marriage contract is hereto attached as Annex “A”); and

4. That after said marriage, she desires to adopt and use her
husband’s surname, “________,” as her own, in order for her to
use the name “________________” in all her legal/official
transactions.

PRAYER

WHEREFORE, the petitioner most respectfully prays that this

Honorable Office CHANGE her name in the Roll of Attorney’s from
__________ to ________________.

___________ City for Manila, (date).

Signature

Page 1 of 2
 VERIFICATION AND
CERTIFICATION OF NON FORUM SHOPPING

REPUBLIC OF THE PHILIPPINES )

QUEZON CITY ) S.S.

I, _________, of legal age, married, with address at

______________, after having been duly sworn to in accordance with
law, hereby depose and say that:

1. I am the petitioner in the above-entitled Petition;

Xxxxxx

IN WITNESS WHEREOF, I have hereunto set my hand this

____________ at ____________, Philippines

(name and signature)

SUBSCRIBED AND SWORN TO before me, this __________, affiant

having exhibited to me, her __________ (ID) valid until
_______________, as competent evidence of her identity.

(Notarizing officer)

Page 2 of 2