RA 9048 Form No-clerical Error in Birth Cert

1

RA 9048 Form No. 1.1. (LCRO) (Devised 10 Aug. 2011) Republi o! "#e $#ilippi%es Lo&l Civil Regis"r' Oe $rovi%e Ci"' Ci "'+, +,u% u%i iip ip&l &li" i"' ' Republi o! o! "# "#e $# $#ilippi%es

) ) --

$eo% No.

PETITION FOR CORRECTION OF CLERICAL ERROR IN THE CERTIFICATE OF LIVE BIRTH

/

o! leg&l &ge



(Comple"e %&me o! peo%er)

(N&o%&li"'+Cie%s#ip)

&%d & reside%" o!

 (Comple"e &ddress)

&er bee% #&vi%g dul' s3or% "o i% &ord&%e 3i"# l&3 l&3 #ereb' del&re "#&" 1) / &m "#e "#e peo%er peo%er seei% seei%g g "#e #&%g #&%ge e o! 5rs" 5rs" %&me i% i% &) m' Cer5&"e o! Live 6ir"# b) 7#e Cer5&"e o! Live 6ir"# o! (Comple"e %&me o! o3%er)

3#o is m'

. (Rel&o% o! o3%er "o "#e peo%er)

2)

/+e+-#e 3&s bor% o%

&"



(D&"e o! 6ir"#)

(Ci"'+,u%iip&li"')



.

($rovi%e)

(Cou%"r')

) 7#e bir"# 3&s reorded u%der regis"r' %umber 4) 7#e leri&l error(s) "o be orre"ed is (&re) (Use additonal shees, if necessary .) .) Item No.

Descripon

From

. To

:) 7#e !&"s+re&so%s !or 5lli%g "#is peo% &re "#e !ollo3i%g (Use additonal shees, if necessary .)

;) / submi" "#e !ollo3i !ollo3i%g %g doume%"s "o suppor" "#is peo% (Use additonal shees, if necessary. ) &) b) ) d) e) <) / #&ve %o" 5led &%' simil&r peo% &%d "#&" "o "#e bes" o! m' %o3ledge %o o"#er simil&r peo% is pe%di%g 3i"# &%' LCRO Cour" o! $#ilippi%e Co%sul&"e. Co%sul&"e. 8) / &m 5li%g "#is peo% &" "#e LCRO o!  (Ci"'+,u%iip&li"')

($rovi%e)

i% &ord&%e 3i"# R.A. No. 9048 &%d i"s impleme%%g rules &%d regul&o%s.

-ig%&"ure Over $ri%"er N&me o! $eo%er

=>R/F/CA7/ON

2

/  "#e peo peo%er %er #ere #ereb' b' er!' "#&" "#e &lle &lleg& g&o%s o%s erei% &re "rue &%d orre" "o "#e bes" o! m' %o3ledge &%d belie! belie!..

-ig%&"ure over $ri%"ed N&me o! $eo%er

-?6-CR/6>D AND -@ORN "o be!ore me "#is d&' o! i% "# "#e e i i"' "'+m +mu u%i %ii ip p&l &lii"' o!  pe eo o%e %err e# #ib ibi i% %g #i #iss Co Comm mmu% u%i" i"' ' 7& Ce Cer r5 5& &"e No. issued &" o% .

Admi%is"eri%g Oe

Do. No. $&ge No No. 6oo No. -eries o!

BBBBBBBBBBB BBBBBBBBBBB BBBBBBBBBBB BBBBBBBBBBB BBBBBBBBB BB

 BBBBBBBBBBBBBBBB  BBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBB BBBBBB For C+,CR use o%l'

AC7/ON 7A>N 6 7> C+,CR Er&%"ed

De%ied ($rovide "#e b&sis !or de%i&l.)

D&"e Ci"'+,u%iip&li"' Civil Regis"r&r

 BBBBBBBBBBBBBBBBB  BBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBB BBBBBBB For CRE use o%l'

AC7/ON 7A>N 6 CRE Armed

/mpug%ed

D&"e Ci"' Regis"r&r Ee%er&l

C6L+11Aug01

O.R. No. Amou%" $&id D&"e $&id