REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

FOURTH JUDICIAL REGION
Branch ______
Antipolo City
IN THE MATTER OF CANCELLATION/
CORRECTION OF ENTRIES IN THE
DEATH CERTIFICATE OF
Special Proc. No. ________
PAULITO BERDAN y BENAVIDEZ
PAULENE KAZEL C. BERDAN
Petitioner,
---versus--CIVIL REGISTRAR OF ANTIPOLO CITY,
REMEDIOS NIEVES, JUN N. BERDAN,
Remylito N. Berdan, Jackielyn N. Berdan,
Jasper Paul N. Berdan, Jeffrey Paul
N. Berdan, AND ALL PERSONS/ ENTITIES WHO/
WHICH MAY BE AFFECTED THEREBY,
Respondents.
x--------------------------------------x
PETITION
COMES NOW the petitioner through the
undersigned counsel, and unto this Honorable Court most
respectfully alleges and avers:
1. That Petitioner is of legal age, single and a resident of
13 Kulas Solano St., Brgy. Kat- Bayani, Tanay, Rizal
1980, where she may be served with summons and
other court processes. She is the illegitimate
daughter of deceased Paulito Berdan y Benavidez as
evidence by her Certificate of Live Birth hereto
attached as Annex A and made an integral part of
this Petition;
2. That Public Respondent, Civil Registrar of Antipolo
City, is the office in-charge of the registration and
correction of entries where the fact of death of
petitioners father, PAULITO BERDAN y BENAVIDEZ
was registered, which registrar is located at Office of

the Local Civil Registrar, GAD Center Building, M.L.

Quezon corner Carigma St., Brgy. San Roque, Antipolo
City, where it may be served with summons and
other court processes;
3. That Respondents, Remedios Nieves, is the former
wife of deceased Paulito Berdan, while Jun Berdan,
Remylito N. Berdan, Jackielyn N. Berdan, Jasper Paul
N. Berdan, Jeffrey Paul N. Berdan are Paulitos
children during his marriage with Remedios, all of
them are residing at 12 M.L. Quezon St., Brgy. KayButo Tanay, Rizal 1980, where they may be served
with summons and other court processes;
4. That at the time of the death of petitioners father on
June 1, 2015, Paulitos marriage with his former wife,
Remedios Nieves was already annulled way back year
2008 as evidence by the NSO copy of the Marriage
Contract of Paulito Berdan and Remedios Nieves. The
said Marriage Contract appears to bear an annotation
on the right portion which reads:
REMARKS: PURSUANT TO THE DECISION
DATED JANUARY 14, 2008 RENDERED BY
JUDGE EDGAR DALMACIO SANTOS OF THE
REGIONAL TRIAL COURT, FOURTH JUDICIAL
REGION, BRANCH 78, MORONG, RIZAL,
UNDER CIVIL CASE NO. 06-1791-M, THE
MARRIAGE BETWEEN THE HEREIN PARTIES
CELEBRATED ON NOVEMBER 6, 1972 IS
HEREBY DECLARED NULL AND VOID AB
INITIO.
NSO copy of the Marriage Contract between Paulito
Berdan and Remedios Nieves is hereto attached as
Annex B and made an integral part of this Petition;
5. That when Paulito died on June 1, 2015 in Clinica
Antipolo, petitioner together with her mother Leonila
C. Berdan were asked by the medical record staff,
Ehdel C. Santos III, who prepared the Certificate of
Death of Paulito Berdan, to provide personal
information of the deceased;
6. That petitioner and her mother gave only the true
and correct information supplied in the Certifcate of

Death of Paulito Berdan such as his civil status as

ANNULLED;
7. That when petitioner secured a copy of the said
Death Certificate from City Civil Registrar of Antipolo,
what was entered and what appeared therein as
regard the status of the deceased was MARRIED
instead of ANNULED his true and correct status.
Copy of Death Certificate is hereto attached as Annex
C and made an integral part of this Petition;
8. That even before the petitioner secured a copy of the
Death Certificate, she became aware of the
misrepresentation made by her half brother, Jun
Berdan, when the latter presented a falsified
document before the Office of the City Civil Registrar
of Antipolo to effect the change of entry in the status
of deceased Paulito from ANNULED to MARRIED;
9. That said Certificate of Death was already forwarded
to NSO, Quezon City before the necessary correction
has to be made. Hence petitioner has therefore filed
this petition, for the correction of the entry as
appearing in Paulitos Certificate of Death as to his
status from MARRIED to ANNULED.
PRAYER
WHEREFORE, it is most respectfully prayed of
this Honorable Court, that after due notice, publication and
hearing, an Order be issued ordering the Office of the City
Civil Registrar of Antipolo, to effect the correction of the
entry as appearing in the Certificate of Death of PAULITO
BERDAN Y BENAVIDEZ as to his status from MARRIED
to ANNULED and to issue a new Certificate of Death with
the said correction.
Petitioner prays for such other reliefs that are just
and equitable under the premises.
September 7, 2015, Antipolo City, Philippines.

Counsel for the Petitioner

VERIFICATION AND CERTIFICATION

I, PAULENE KAZEL C. BERDAN, of legal age, Filipino
citizen and a resident of 13 Kulas Solano St., Brgy. KatBayani, Tanay, Rizal 1980, subscribing under oath hereby
depose and state that:
1. I am the petitioner in the above entitled petition;
2. I have caused the preparation and fi ling of the
foregoing Petition;
3. I have read and understood the contents thereof,
and I attest to the truth of the factual allegations
therein, of my own knowledge and authentic
records;
4. I further certify that no other actions or
proceeding involving the same issue raised in
this Petition has been commenced and/or
pending with the Supreme Court or any Division
thereof, courts or any other tribunal or agency;
5. Should I learn that a similar action or proceeding
has been fi led or is pending with the Supreme
Court, or any other courts, tribunal or agency, I
undertake to inform this Honorable Court within
fi ve (5) days from notice thereof;
IN WITNESS WHEREOF, I have hereunto set my
signature this _____ day of _____________ 2015 at the
_________________, Philippines.

PAULENE
KAZEL
BERDAN
Affi ant

C.

SUBSCRIBED AND SWORN, to before me this

_____ day of ___________, 2015 at __________________,
Philippines, Affi ant exhibiting to me her valid
Identifi cation Card No. __________
issued on
__________ at _________________.
Doc. No.____
Page No.____

Notary Public

Book No. ____

Series of 2015