Republic of the Philippines

REGIONAL TRIAL COURT

7th Judicial Region
Branch_________
_____________ City

IN RE: PETITION FOR

ADOPTION BY STEPPARENT

Case No.___________

__________________________
Petitioner,
x---------------------------------------/

PETITION

COME NOW, the Petitioner, unto this Honorable Office, most

respectfully state, to wit:

1. Petitioner is of legal age, Filipino, single, with resident at

_____________;

2. Petitioner is the husband of _______________, who is the mother of

_____________, the above-named minor, and thus petitioner is the
stepfather of the minor;

3. The minor, ________________ is a male/female of the age of ___ years;

4. The minor is an issue of the marriage of ______________ and

_______________ [petitioner’s wife] and was born at
____________[address], on ______________;

5. On _______________[date], _______________[wife] was granted a

decree of divorce from ________________ [husband]. Copy of decree is
attached herewith and made part hereof as Annex “A”;
6. _________________[father] resides at _______________, has willfully
failed to pay for the care, support, and education of the minor, although
able to do so;

7. On _________________[date], ________________________ [mother]

was married to petitioner at ________________ and is now known as
________________, and since such date has resided with petitioner as
his wife; __________________[child] has since the date of the marriage,
continuously resided with his/her mother and with petitioner;

8. Petitioner is a fit and proper person to be allowed the care, custody, and
control of the minor, jointly with the minor’s mother. Petitioner is well
able to care for, maintain, support and educate the minor as if he/she
were the natural child of petitioner. Petitioner desires, if and when he is
permitted to adopt the minor, that the minor shall take the family name of
petitioner and shall be known as _______________;

9. Petitioner desires that the minor, when adopted, shall bear to petitioner
the relationship of a natural child toward his/her parent and shall have all
the rights and shall bear all the duties of the relationship. Petitioner is
willing and agrees that, on adoption, he shall bear the relationship of a
natural parent to the minor with all the rights and duties and adoptions of
that relationship. Petitioner further agrees to all the above matters and
promises and to the consequences of assuming the relationship of a
natural parent with the minor.

WHEREFORE, premises considered it is respectfully prayed for to

the Honorable Office that;

1. Such investigation and examination of the proposed adoption be made as

required by law;

2. The court, on the hearing of this petition, render its decree that the minor
________________ shall be and is adopted by petitioner as petitioner’s
child;

3. It be declared that the minor shall owe to petitioner all the duties and
obligations of a child to its natural parent and shall be entitled to exact
from petitioner all the rights and privileges of a natural child from child’s
father;

4. On the granting of the adoption, the minor child shall bear and be known
by and be entitled to the name of _________________;
5. Petitioner be adjudged to have, with _____________[mother], the care,
custody, and control of the minor child and to have the status of a natural
father to the minor child;

6. The minor be treated and regarded in all respects as the child of

petitioner.

Other reliefs considered just and equitable are likewise prayed for.

RESPECTFULLY SUBMITTED. This _____ day of ______, 2022,

in _________ City, for __________ City, Philippines.

____________________________
Petitioner
ID & No. _______________________
Date issued: _____________________
Expiry date:______________________
REPUBLIC OF THE PHILIPPINES )
MANDAUE CITY ) S.S.

VERIFICATION AND CERTIFICATION AGAINST FORUM

SHOPPING

I, _____________________________, of legal age, Filipino citizen,

married, and a resident of __________________________, after being
sworn to, hereby depose and state, that:

I am the petitioner of the above-entitled case;

I have caused the preparation of the foregoing Petition for

Appointment as Notary Public and have read and understood the contents
and allegations therein and that the same are true and correct to the best of
my personal knowledge and based on authentic records and documents;

I hereby certify that I have not heretofore commenced any other

action involving the same or similar issue in court, tribunal or quasi-judicial
agency and to the best of my knowledge, and no such action or claim is
pending therein;

If I should hereafter learn that a similar action has been filed or is

pending before said bodies or agencies, I shall promptly inform the aforesaid
courts and other tribunal agency within five (5) days therefrom;

The case is not filed to harass, cause unnecessary delay, of needlessly

increase the cost of litigation; and

The factual allegations therein have evidentiary support or, if

specifically so identified, will likewise have evidentiary support after a
reasonable opportunity for discovery.

The content of this Verification/Certification Against Forum

Shopping was explained to me in the language I am speaking and most
familiar with.
 IN WITNESS WHEREOF, I have hereunto affixed my signature
this ____ day of ________ 20__ in _________________, Philippines.

_________________________________
Affiant
ID & No. _______________________
Date issued: _____________________
Expiry date:______________________

SUBSCRIBED AND SWORN to before me this ___ day of _____

20__, in _______________________, Philippines, affiant exhibiting to me
her competent proof of identity as indicated above.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2022.