REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

NATIONAL CAPITAL JUDICIAL REGION
BRANCH____, QUEZON CITY

In The Matter of the Adoption

of the minors, ABC and DEF,

Special Proc. No._______

For: Adoption

EFG
Petitioner,
x-----------------------------------------x

PETITION
COMES NOW petitioner EFG, through the undersigned
counsel, and unto this Honorable Court respectfully alleges:

1.

Petitioner is of legal age, Filipino, single and a resident

of _______________, Quezon City. Copy of petitioner’s
Barangay Certificate of Residence at said address since 2003
until the present is attached and made integral part of this
petition as Annex “A”;

2.

Petitioner, who is possessed of his full civil capacity and

legal rights, and of good moral character, and has not been
convicted of any crime involving moral turpitude, wishes to
adopt his minor niece, ABC, and his minor nephew, DEF both
surnamed YLO, whose mother JKL, sister of herein petitioner
had died on _____________, inasmuch said minors are
presently under his care and custody. Copy of the Death
Certificate of the minors’ mother is likewise attached and
made integral part of this petition as Annex “B”;
3.

The minors herein sought to be adopted, ABC and DEF,

both surnamed LMN, were born on ___________ and
________________, respectively, in Quezon City. Copies of their
respective Certificate of Live Birth duly issued by the NSO
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are attached and made integral parts of this petition as

Annex “C” and “D”, respectively;

4.

The minors’ biological father, QRS, is expressing his

consent to the adoption sought by petitioner, who considers
said minors as his children, having loved, cared, supported
them since the death of their mother until the present. Copy
of the father’s Affidavit of Consent is attached and made
integral part of this petition as Annex “E”;

5.

The petitioner is qualified to adopt the said minors, and

will be able financially and morally to continue bringing up
and educate said minors properly and adequately, since their
father presently has no capacity to do so and may in the
near future be able to marry another woman.

PRAYER

WHEREFORE, petitioner pray that, after due notice,

publication and hearing, a judgment be rendered, as
follows:

1.) That henceforth, the minors ABC and DEF, both

surnamed LMN, be the adopted and considered child of the
petitioner;

2.) That copy of the Decision be furnished to the Local

Civil Registrar of Quezon City for the corresponding entry in
Civil Registrar; and

3.) For such reliefs as may be granted under the

premises

Manila for Quezon City, July 22, 2015.

XYZ
LAW OFFICES
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Counsel for Petitioner

By:

Verification next page……………..

VERIFICATION / CERTIFICATION

I, HIJ, of legal age, and with address at ____________,

Quezon City, after being duly sworn, depose and say:

1. THAT as the Petitioner in the above entitled case, I

have caused the preparation of the foregoing Petition; that I
have read the same and the allegations therein are true and
correct of my own personal knowledge;

2. THAT I hereby certify that, except the proceedings

that gave rise to this Petition, I have not heretofore
commenced against respondents any other action or
proceeding involving the same issues in the Supreme Court,
the Court of Appeals, or any other tribunal or agency; that to
the best of my knowledge, no such action or proceeding is
pending before said entities; and, that should I hereafter
learn that a similar action or proceeding has been filed or is
pending before the Supreme Court, the Court of Appeals or
any other tribunal or agency, I undertake to report that fact
to this Honorable Court within five (5) days therefrom.

HIJ
Affiant

SUBSCRIBED AND SWORN to before me at Manila

Philippines, this_____ day of July ______________ by: affiant HIJ
who has satisfactorily proven her identity to me thru her
Government ID NO.____________________

Said affiant is the same person who personally signed

the foregoing Verification / Certification before me and
acknowledged to me that she voluntarily executed the same.

NOTARY PUBLIC
Doc. No. _____;
Page No. _____;
Book No. _____;
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Series of 2015.