Vous êtes sur la page 1sur 4

Republic of the Philippines

REGIONA TRIAL COURT


Tuguegarao City
Second Judicial Region
Tuguegarao City, Cagayan

RE: CORRECTION OF ENTRY


IN THE CERTIFICATE OF LIVE
BIRTH OF BONG NAVARRO KEPT IN THE
OFFICE OF THE LOCAL CIVIL
REGISTRAR OF TUGUEGARAO CITY,
Petitioner,

SPL. PROC. NO.___________

- versus
FLOR DE LIZA, IN HER CAPACITY
AS THE LOCAL CIVIL REGISTRAR
OF TUGUEGARAO CITY
Respondent,

JUDICIAL AFFIDAVIT OF
BONG NAVARRO

I, Bong Navarro of legal age, single, and living Carig Sur Tuguegarao, Cagayan petitioner
in this case, state under oath as follows:
PRELIMINARY STATEMENT
The person examining me is Atty. Kimberley Matammu with address at Carig Sur
Tuguegarao City. The examination is being held at the same address. I am answering her
questions fully conscious that I do so under oath and may face criminal liability for false
testimony and perjury.
This affidavit/testimony of petitioner Bong Navarro is being offered to prove that his date of
birth and his gender were erroneously registered. The petitioners testimony is also offered
Directing the Local Civil Registrar of Tuguegarao City to cause to be made the correction of his
erroneous birth date and his erroneous gender
1. Q. Please state your name and other personal circumstances for the record.
A. I am Bong Navarro, 29 years old, Carig Sur Tuguegarao City, Cagayan
2.

Q. Are you the same Bong Navarro, the petitioner in this case?
A. Yes maam.

3.

Q. Do you have any proof that your birth is being registered in Local Civil Registrars?
A: Yes maam. The Authenticated Certificate of Live Birth, issued by the National Statistics

Office. ( Exhibit A)
4. Q: Are the information in your Certificate of Live birth correct?
A: No Maam.
5. Q: What particular information in your live birth is erroneously registered?
A: The date of my birth and my gender.
6: Q: What was the date of your birth being erroneously registered?
A: October 27 1985, this should correctly be registered as October 07, 1985
7. Q: Do you have any proof that it should be October 07, 1987?
A: Yes maam. My SECONDARY STUDENTS PERMANENT RECORD, CERTIFICATE
OF BAPTISM, HIGHSCHOOL ID, VOTERS ID, SCHOOL ID,( marked as Exhibits B, C,
D, E and F)
8. Q: How about your gender?
A: I was registered as FEMALE, which is erroneous; the same should correctly be
registered therein as MALE
9. Q: Do you have any proof that it was erroneously registered?
A: Yes maam. Certification issued by Dra. Pat Ricka, Municipal Health Officer of the
Municipal Health Office of Tuguegarao City,(Exhibit G)
10. Q: What are the effects of this erroneous information to you?
A: Such discrepancy greatly affects my personal data, and in order to avoid confusion and to
remedy the problem, I humbly ask the court to direct the Local Civil Registrar to cause to be
made the correction of the my erroneous birth date, as appearing in my Authenticated Certificate
of Live Birth (Annex A) from October 27, 1985 to October 07, 1985, and my erroneous
gender, from FEMALE to MALE,

IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of December
2014 at Tuguegarao City.
Bong Navarro
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for Tuguegarao City
Cagayan this 13th day of December 2014. Affiant personally came and appeared with Voters ID
issued by the COMELC on July 13, 2014 at Tuguegarao City bearing his photograph and

signature, known to me as the same person who personally signed the foregoing instrument
before me and avowed under penalty of law to the whole truth of the contents of said instrument.

Doc. No. ____


Page No. ____
Book No. ____
Series of 20__

Atty. KIKAY VILLA


Notary Public
Commission Serial No. 123456
Notary Public for Tuguegarao City, Cagayan
Until December 31, 2015
Office: Montilla st. CArig Sur Tuguegarao City
Roll No. 34567
IBP Lifetime Roll No. 12345-56; 05/05/13 ; Cagayan
PTR No. 123457 04/13/13 ; Cagayan
MCLE Compliance Cert. No. 45678; 04/04/13

I, Kimberley Dela Cruz- Matammu, of legal age, Filipino, with postal address Carig
sur Tuguegarao City after being duly sworn depose and say:
1. I was the one who conducted the examination of witness John Juan at my
aforementioned office in Carig Sur Tuguegarao City;
2. I have faithfully recorded or caused to be recorded the questions I asked and the
corresponding answer that the witness gave;
3. I nor any other person then present or assisting her coached the witness regarding her
answers;
IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of December
2014 at Tuguegarao City,Cagayan
ATTY.KIMBERLEY DC. MATAMMU
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for Tuguegarao City
Cagayan this 13th day of December 2014. Affiant personally came and appeared with Voters ID
issued by the COMELC on July 13, 2014 at Tuguegarao City bearing his photograph and
signature, known to me as the same person who personally signed the foregoing instrument
before me and avowed under penalty of law to the whole truth of the contents of said instrument.

Doc. No. ____


Page No. ____
Book No. ____
Series of 20__

Atty. KIKAY VILLA


Notary Public
Commission Serial No. 123456
Notary Public for Tuguegarao City, Cagayan
Until December 31, 2015
Office: Montilla st. CArig Sur Tuguegarao City
Roll No. 34567
IBP Lifetime Roll No. 12345-56; 05/05/13 ; Cagayan
PTR No. 123457 04/13/13 ; Cagayan
MCLE Compliance Cert. No. 45678; 04/04/13