Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
1 (LCRO)
(Devised 15 Aug. 2001)
SAMPLE
REPUBLIC OF THE PHILIPPINES
LOCAL CIVIL REGISTRY OFFICE
Province of Pangasinan
XXXXXXXX
XXXXXXX
CITY OF ALAMINOS
(nationality/citizenship)
and a resident of
____________________________________________________________________
(complete address)
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 Marriage entered into with
______________________________________
(complete name of spouse)
who is my ___________________________________________________________________
(relation of owner to the petitioner)
(city/municipality)
_______________________________________, ____________________________________.
(province)
(country)
Description
From
To
5. The facts/reasons for filling this petition are the following: (Use additional
sheets, if necessary.)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
6. I submit the following documents to support this petition: (Use additional
sheets, if necessary.)
a) ________________________________________________________________________
b) ________________________________________________________________________
c) ________________________________________________________________________
d) ________________________________________________________________________
7. I have not filed and similar petition and that, to the best of my knowledge, no
longer similar
petition is pending with any LCRO, Court or Philippine Consulate.
8. I am filing this petition at the LCRO of ______________________,
_______________________
(city/municipality)
(province)
in accordance with RA No. 9048 and its implementing rules and regulations.
__________________________________
Signature over printed name of petitioner
SAMPLE
VERIFICATION
Doc. No.
________________
__________________________
Administering Officer
Series of ________________
SAMPLE
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Date: _____________________
_____________________________
City / Municipal Civil Registrar
Impugned
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Date: ____________________________
___________________________
Civil Registrar General
________________
Amount Paid
________________
Date paid
________________
SAMPLE