Petition for Change of First Name

I, _______________________________, of legal age, ________, (complete name of petitioner) (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 Live Birth
b) the Certificate of Live Birth of _____________________________________ who is my
(complete name of owner) _______________________________________________________ (relation of owner to the petitioner)

2. I/He/She was born on ______ at _________________________ (date of birth) (city/municipality) _______________________________, ____________________. (province) (country)

3. The birth was recorded under registry number ___________________________.

4. The first name to be changed is from ________ to ___________.

5. The grounds for filing this petition are the following:

(Ground selected should be explained/justified in a separate sheet of paper to be attached to this form.)
a) The first name is extremely difficult to write or pronounce;
b) I have/He/She has habitually and continuously used ____ and I/He/She is publicly known in the community with that first name;
c) The first name is tainted with dishonour;
d) The first name ridiculous;
e) The first name causes confusion:
f) Other: (Specify) _____________________________________________

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


I, ____________________________________________, the petitioner, hereby certify that the allegations herein are true and correct to the best of my knowledge and belief.

Signature over printed name of petitioner