Republic of the Philippines

REGIONAL TRIAL COURT

7th Judicial Region
Branch ___, Cebu City

IN RE: PETITION FOR CORRECTION SPL PRO. NO. ______

OF ENTRIES IN THE CERTIFICATE OF
LIVE BIRTH OF JENNIFER BAS Y KHO
SPECFICALLY HER DATE OF BIRTH
FROM MAY 20, 1963 TO APRIL 3, 1963

JENNIFER BAS Y KHO

Petitioner,
- versus –

THE CITY CIVIL REGISTRAR OF

CEBU CITY
Respondent.
x-----------------------------------------------/

PETITION FOR CORRECTION OF ENTRIES IN THE CERTIFICATE

OF LIVE BIRTH OF JENNIFER BAS Y KHO

PETITIONER, through and by the understated counsel unto this

Honorable Court, most respectfully moves to correct the entries in her
Certificate of Live Birth ans states that:

1. Petitioner is of legal age, married, a Filipino citizen with residential

and postal address at 157 R. Duterte St., Banawa, Cebu City, where
she may be served with the legal processes of this Honorable Court;

2. She is the legitimate daughter of spouses BARTHOLOMEW BAS

and LILIAN BAS. The petitioner was born on APRIL 3, 1963 in Cebu
City;

3. Her birth was duly registered with the Office of the Local Civil
Registrar of Cebu City and entered in the Registry of Births under
Local Civil Registry No. 4321;

4. The petitioner retained the duplicate original of her Certificate of

Live Birth, attached herein and marked as Annex "A";

5. However, when she secured a copy of her Certificate of Live Birth

at the National Statistics Office, she discovered that her date of birth
was erroneously entered as May 20, 1963, attached herein and
marked as Annex "B";

6. The petitioner has always indicated in her transactions that he was

born on April 3, 1963. These transactions are supported by the
following documents and attached herein as:

DOCUMENT MARKING
 Department of Education Annex “C”
Form 137-A, wherein under
the entry Date of Birth Year:
1963 was entered, under
entry Month: April was
entered, and under the
entry Day: 3 was entered.
 Bureau of Internal Annex “D”
Revenue, Tax Identification
Number 4235465 where in
enty Date of Birth: 04-03-63
was entered.
 Philippine Health Insurance Annex “E”
Corp., Member Data
Record, PhilHealth
Identification Number
190018272873 wherein
under the entry Date of
Birth: 04/03/1963 was
entered.
 Land Transportation Office, Annex “F”
Driver’s License under the
entry of Date of Birth: 1963-
04-03 was entered.
 Professional Regulation Annex “G”
Commission, Registered
Nurse License, 4/3/1963
was entered as birth date
 Barangay Clearance, Annex “H”
Baragay Banawa wherein it
was entered that he was
born on April 3, 1963
 National Bureau of Annex “I”
Investigation Clearance,
wherein under the entry
Date of Birth: April 3, 1963
was entered.
7. Following Sections 1 and 2, Rules 108 of the Revised Rules of
Court, which provides that:

Section 1. Who may file petition. — Any person

interested in any act, event, order or decree concerning
the civil status of persons which has been recorded in
the civil register, may file a verified petition for the
cancellation or correction of any entry relating thereto,
with the Court of First Instance of the province where
the corresponding civil registry is located.

Section 2. Entries subject to cancellation or correction.

— Upon good and valid grounds, the following entries in
the civil register may be cancelled or corrected: (a)
births: (b) marriage; (c) deaths; (d) legal separations;
(e) judgments of annulments of marriage; (f) judgments
declaring marriages void from the beginning; (g)
legitimations; (h) adoptions; (i) acknowledgments of
natural children; (j) naturalization; (k) election, loss or
recovery of citizenship; (l) civil interdiction; (m) judicial
determination of filiation; (n) voluntary emancipation of
a minor; and (o) changes of name.

8. Hence, the petitioner filed this petition to correct the entry in his
Certificate of Live Birth, specifically his Date of Birth from May 20,
1963 to April 3, 1963.

PRAYER

WHEREFORE, premises considered, it is most respectfully prayed of

the honorable court that an order be issued ordering the correction of
entry of DATE OF BIRTH from May 20, 1963 to April 3, 1963.

Other reliefs just and equitable under the law are likewise prayed for.

29th day of January 2018 in the City of Cebu, Philippines.

MA. INA G. ROA

Counsel for Petitioner
Unit 123 Keppel Building
Cebu Business Park, Cebu City
PTR No. 12345678; January 3, 2018, Cebu City
IBP No. 654321; Lifetime
Roll of Attorney No. 25994
REPUBLIC OF THE PHILIPPINES)
City of Cebu)S.S.

VERIFICATION AND
CERTIFICATION AGAINST FORUM-SHOPPING

I, JENNIFER K. BAS of legal age, Filipino, single and a resident of

157 R. Duterte St., Banawa, Cebu City, after being sworn to in
accordance with law hereby depose and state that:

1. I am the petitioner in the above entitled case;

2. I have caused the preparation of the above Petition and I have
read the same and knows the contents thereof;
3. The allegations contained therein are true and correct of my
own personal knowledge;
4. I further certify that:
a. I have not theretofore commenced any other action or
proceeding or field any claim involving the same issues or
matter in any court, tribunal, or quasi-judicial agency and;
b. To the best of my knowledge no such action or
proceeding is pending therein;
c. If I should thereafter learn that the same or similar action
or proceeding has been filed or is pending before the
Supreme Court, the Court of Appeals or any other tribunal
or quasi-judicial agency, I undertake to report such fact
within five (5) days therefrom to the court or agency
wherein the original pleading and sworn certification
contemplated herein have been filed.

INWITHESS WHEREOF, I have hereunto set my hands this

th
29 day of January 2018 at Cebu City Philippines.

JENNIFER K. BAS
Affiant

JURAT

Subscribed and sworn to before me this 29th day of January

2018 at Cebu City Philippines.