Republic of the Philippines

10th Judicial Region

REGIONAL TRIAL COURT
Branch 6
Prosperidad, Agusan del Sur

IN THE MATTER OF THE SP. PRO. NO. 944-2018

PETITION FOR THE
CORRECTION OF ENTRIES IN
THE REGISTRATION OF LIVE
BIRTH OF JEAN COLIS
VALLESPIN,

JEAN COLIS VALLESPIN,

Petitioner,

-versus-

OFFICE OF THE MUNICIPAL

CIVIL REGISTRY OF
PROSPERIDAD, AGUSAN DEL
SUR.
Respondent.
x- - - - - - - - - - - - - - - - - - - - - - - -/

JUDICIAL AFFIDAVIT OF
JEAN COLIS VALLESPIN,

PRELIMENARIES: The person examining me is Atty. Marceliano Monato

III his office address at Patin-ay, Prosperidad, Agusan del Sur. The
examination is being held at the same address. I am answering his questions
fully conscious that I do so under oath and may face criminal liability for
false testimony and perjury.

PURPOSE: This affidavit/testimony of petitioner JEAN COLIS

VALLESPIN, is being offered to prove that her middle name is Colis and
surname is Vallespin, and she has been using the said name since birth, and
that she will testify on related matters regarding this petition.

1. Q: Please state your name and other personal circumstances for the
record.
A: I am JEAN COLIS VALLESPIN, Filipino, single, of legal age,
and presently residing at Purok 8 Los Arcos, Prosperidad, Agusan del
Sur. A high school graduate and a "kasambahay" or domestic helper
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 working in Luzon. I am the youngest of the eight children of Spouses
ANTONIO D. VALLESPIN and ESTRELLANA R. COLIS
(deceased).

2. Q: Are you the same JEAN COLIS VALLESPIN, the petitioner in

this case?
A: Yes Sir.

3. Q: What is your purpose in coming here today?

A: To voluntarily give my statement regarding the petition I filed,
before the Honorable court for the correction of erroneous entry in
item No. 1 of my Certificate of Live Birth (CLB for brevity)

4. Q: Can you give a brief background of this case?

A: Yes sir. I am a "kasambahay" or house helper working in Luzon.
Sometime in May 2019, I my employer told me that they will register
me as member of Social Security System (SSS) and Phil Health. But
first, I have to secure my authenticated birth certificate as it was one
of the requirements. When I secure my Philippine Statistics Authority
(PSA) birth certificate, I was surprised when item No. 1 shows my
name as JEAN COLIS. The surname COLIS appears hand written,
with a counter signature above it. Hereto attached is a PSA copy of
the said Certificate of Live Birth marked as Annex “A”. I believe that
the PSA made a mistake in the entries.

5. Q: What made you say that PSA commit mistake?

A: Because in the birth certificate issued by LCR, my name is JEAN
COLIS VALLESPIN, and during my elementary and high school, I
presented such birth certificate during enrolment. I have been known
and use the said name since I was young. As a matter of fact, the
Punong baragay of Borbon Butuan City, where we also have
residence, issued a certification that I am known as JEAN COLIS
VALLESPIN. My High School Card (Department of Education-
Secondary Student's Permanent Record) also indicate that I am using
the name JEAN COLIS VALLESPIN. Copy of Department of
Education-Secondary Student's Permanent Record is hereto attached
as ANNEX "C", and Copy of Barangay Certification attached as
ANNEX "D"

6. Q: Are you aware that your parents were not married at the time of
your birth?
A: Yes I am aware, but my parents got married thereafter and my
mother subsequently process my late registration in LCR thereafter.
So I can say I am a legitimate child. Copy of Marriage certificate
between the parents of petitioner is hereto attached and marked as
ANNEX "E"
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 7. Q: What did you do when you discover that your surname became
COLIS in the PSA Birth Certificate?
A: First I wonder how did it happen. I compared the PSA birth
certificate and the birth certificate issued by Municipal LCR.
(ANNEX "B" and ANNEX "B-1"). Upon examining both
documents, I noticed that the signature of then Municipal Local Civil
Registrar, Cerina D. Gallocanta, is similar with the countersign
signature above my surname in the PSA Birth certificate. It can be
seen that then Municipal Local Civil Registrar, Cerina D. Gallocanta,
affixed her initials on top of my surname which she wrote as
“COLIS” and with no middle name attached to my name.

8. Q: What did you do after?

A:I went to Prosperidad Municipal LCR to inquire what happened and
what should I do.

9. Q: What was the advise of the LCR?

A: He said that I should seek lawyer's assistance to file petition for
correction of entry in Item No. 1 in my birth certificate.

10.Q:Does your father acknowledge you as his child?

A: Yes sir, my father signed the Affidavit of
Acknowledgment/Admission of Paternity at the back of my birth
certificate. (ANNEX B-1)

11.Q: What do you want from the Honorable Court?

A: I humbly pray before this Honorable Court that an order be issued
DIRECTING the Office of the Municipal Civil Registry of
Prosperidad, Agusan del Sur to CORRECT item number 1 of my
Certificate of LIVE Birth from "JEAN COLIS" to "JEAN COLIS
VALLESPIN" and accordingly INFORM the Philippine Statistics
Authority.

12.Q: I have no further question. Do you understand your affidavit?

A: Yes I understand.

13.Q: Do you voluntarily affirm and confirm that all your answers to this
affidavit are true and correct based on your personal knowledge and
authentic records?
A: Yes I affirm and confirm.

Affiant further sayeth none.

IN WITNESS WHEREOF, I have set my hand this 6th of June 2019

at Prosperidad, Agusan del Sur.
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 JEAN COLIS VALLESPIN
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for

the province of Agusan del Sur this 6th of June 2019. Affiant presented to
me her PhilHealth ID as proof of her identity, known to me as the same
person who personally sign the foregoing Judicial Affidavit before me and
avowed under penalty of law to the veracity of the contents of said
instrument.

ATTY. MARCELIANO P. MONATO III

Notary Public
Until 12-31-2019
Counsel for the Petitioner
Roll of Attorney No. 65377
IBP No. 1068238 Dec 27, 2018/IBP ADS
PTR No. 7336450/Jan 3, 2018/PTO Agusan del Sur
MCLE Compliance No. VI- 001795

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 SWORN ATTESTATION OF THE LAWYER
WHO CONDUCTED THE EXAMINATION

I, Atty. Marceliano P. Monato III, of legal age, with office address at

Purok 13, Poblacion Prosperidad, Agusan del Sur, do hereby state under
oath that:

1. I am the lawyer who conducted and supervised the examination of

GRACE MENDOZA MAURING on June 6, 2019, at my office;

2. I have faithfully recorded the questions I asked and the

corresponding answers that the witness, GRACE MENDOZA
MAURING, gave;

3. Neither I nor any other person then present or assisting him

coached the witness regarding the latter’s answers; and

4. I am fully conscious that any false attestation shall subject me to

disciplinary action, including disbarment.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

6th of June 2019 at Prosperidad, Agusan del Sur.

ATTY. MARCELIANO P. MONATO III

Affiant

SUBSCRIBED AND SWORN to before me this 6th day of June, 2019 in

____________________________

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