PETITION FOR ADOPTION

REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT
NATIONAL CAPITAL JUDICIAL REGION
MANILA, BRANCH 13
In the matter of the
adoption of the minor
RILEY T. KALAYAAN
SP. Proc. No. 12213451
For: Adoption
TERRENCE
G.
SAN
AGUSTIN and EMELIE
D. SAN AGUSTIN,
Petitioners.
x---------------------------------------------------x
PETITION
COMES NOW the petitioners, by the undersigned counsel,
and unto this Honorable Court, respectfully aver:
1. That the petitioners are husband and wife, both of legal
age, and residents of Unit 805, Blue Apartments, Silverio St.,
San Andres, Metro Manila;
2. That they have no legitimate children or descendants
and hereby desire to jointly adopt a minor, named Riley T.
Kalayaan, who is 6 years of age, legitimate child of Peter Lord
T. Kalayaan and Mary Swen S. Kalayaan;
3. That the father of said minor is now dead, and only her
mother, named Mary Swen S. Kalayaan, is alive;
4. That said mother, Mary Swen S. Kalayaan, is not insane,
nor intemperate, nor has she abandoned such minor, and
with full knowledge of petitioners' intention hereby expressly
gives her written consent to the adoption, as evidenced by
Annex "A" hereto attached and made an integral part of this
petition;
5. That the petitioners are qualified to adopt the said
minor, and will be able financially and morally, to bring up
and educate said minor, properly and adequately.
WHEREFORE, it is respectfully prayed that upon due notice
and hearing judgment be entered adjudging that the minor
child Joe S. Tan be freed from all legal obligations of
obedience and maintenance with respect to her natural
parents and that she be declared to all legal intents and
purposes, the child of the herein petitioners, and that her
surname be changed to that of the petitioners.

PETITION FOR ADOPTION

City of Manila, Philippines, 17 February, 2012.

ATTY. JULIAN DE LEON
Counsel for Petitioner
Grand Towers, Malate, Manila
Roll No. 334134
Until Dec. 31, 2013
IBP No. 223427/1-5-08/Manila
PTR No. 3456789/1-208/Manila
MCLE Compliance No.
123456

PETITION FOR ADOPTION

VERIFICATION AND CERTFICATION

WE, TERRENCE G. SAN AGUSTIN and EMELIE D. SAN
AGUSTIN, husband and wife, of legal age and with residence
at of Unit 805, Blue Apartments, Silverio St., San Andres,
Metro Manila, after having been duly sworn, depose and say:
1. That we are the petitioner in the above entitled
petition.
2. That we have read the allegations therein contained,
and that the same are true and correct of my
personal knowledge or based on authentic records.
3. We have not commenced any action or filed any
claim involving the same issues in any court, tribunal
or quasi-judicial agency and to the best of my
knowledge, no such other action or claim is pending
in them; and
4. If we should learn that the same or similar action or
claim has been filed or is pending after its filing, I
shall report that fact within five (5) days from notice
to the court where the petition or initiatory pleading
has been filed
Witness my hand this 17th of February at Manila,
Philippines

TERRENCE G. SAN AGUSTIN

AGUSTIN
Affiant

EMELIE D. SAN
Affiant

JURAT
SUBCRIBED AND SWORN TO before this 17th day of
February, 2012 in the City of Manila, Philippines, affiants
exhibiting to me their Postal IDs No. 11752 and 15232 issued in
Manila on August 11, 2011. I hereby certify that I have examined
the Affiant and that I am fully satisfied that they have voluntarily
executed and understood the contents of their Petition.
ATTY. JULIAN DE LEON
Counsel for Petitioner
Grand Towers, Malate,
Manila
Roll No. 334134
Until Dec. 31, 2013
IBP No. 223427/1-508/Manila
PTR No. 3456789/1-208/Manila

PETITION FOR ADOPTION

Doc. No. 1
Page No. 2
Book No. 3
Series of 2012.