Republic of the Philippines

REGIONAL TRIAL COURT

National Capital Judicial Region

Branch ___

City of Manila

IN RE: PETITION FOR ORIGINAL

REGISTRATION OF TITLE

LRC CASE NO._______

ADRIAN GABRIEL S. ATIENZA,

Petitioner.

X--------------------------------------------------X

PETITION

The undersigned, ADRIAN GABRIEL S. ATIENZA, hereby applies to have the land
hereinafter described brought under the operation of the Property Registration Decree, and to
have the title thereto registered and confirmed:

AND DECLARE:

1. That the applicants is the owner of the land by virtue of possession in accordance with
Title V of the Civil Code, together with the building and improvements thereon. The said land,
consisting of a 300 square meter parcel is situated, bounded and described as shown on the plan
and technical descriptions attached hereto and made a part hereof, as follows:
 “A 300 square meter parcel of land situated in 123 Bagumbayan St., Tondo, Manila,
bounded on the North along, line 1-2 by Lot A-1; bounded on the East, along line 2-3 by
Lot B-7; bounded to the South, along line 3-4 by Lot A-3; and bounded on the West,
along line 1-4 by Lot A-5”;

2. That said land at the last assessment for taxation was assessed at SIX HUNDRED
THOUSAND PESOS (Php 600,000.00), Philippine currency;

3. That to the best of our knowledge and belief, there is no mortgage or encumbrance of any
kind whatsoever affecting said land, nor any other person having any interest therein, legal or
equitable, or in possession;

4. That the applicant has acquired said land in the following manner: that the undersigned
has been in open, continuous, exclusive, and notorious possession and occupation of the land;
that the land the applicant occupies is declared as patrimonial property since January 5, 2010;
and that the undersigned and his predecessors-in-interest have been in possession of the land
since January 6, 1995;

5. That the following persons are occupying the subject land: the undersigned, and his
immediate family;

6. That to the best of the our knowledge and belief, through inquiry with the Register of
Deeds and the Land Registration Authority, no other persons are occupying or in possession of
the adjoining properties;

7. That the applicant is single;

8. That the applicant's full name, age, citizenship, residence, and postal address are as
follows:

FULL NAME: ATIENZA, ADRIAN GABRIEL

AGE: 25 YEARS OLD

CITIZENSHIP: FILIPINO

RESIDENCE AND POSTAL ADDRESS: 321 KAMALAYAN ST., TONDO,

MANILA, PHILIPPINES, 1013;

9. That the applied land is not bounded by a public or a private road;

10. That the following documents are attached and hereto made a part hereof:

a. Original Plan as Annex “A”, hereof;

b. Technical description as Annex “B”, hereof;

c. Tax Declaration, as Annex “C’, hereof;

d. Tax Clearance, as Annex “D”, hereof; and

e. Land Status, as Annex “E”, hereof.

11. That copies of this petitioned has been furnished to the relevant office of the Land
Registration Authority, all other concerned government agencies, and all parties-in-interest.
 PRAYER

The applicant, ADRIAN GABRIEL S. ATIENZA, respectfully prays to this Honorable

Court, that judgment be rendered in his favor, that the land described be brought under the
operation of the Property Registration Decree, and to have the title thereto registered and
confirmed in his name.

Signed at 322 KAMALAYAN ST., TONDO, MANILA, PHILIPPINES this 17 th day of

JUNE 2022.

ADRIAN GABRIEL S. ATIENZA

Applicant
REPUBLIC OF THE PHILIPPINES)
CITY OF MANILA ) S.S.

VERIFICATION/CERTIFICATION OF NON-FORUM SHOPPING

I, ADRIAN GABRIEL S. ATIENZA, am the applicant in the above-captioned case, of legal

age, Filipino, after having been sworn, in accordance with law, hereby depose and state that:

1. I am the Applicant in the above-captioned case;

2. I have read and understood the contents hereof of this PETITION FOR ORIGINAL
REGISTRATION OF TITLE, and the facts herein alleged are true and correct of my own
knowledge and based on available verifiable records;
3. I heretofore have not commenced any other action or proceeding or any claim, or filed
any case involving the same issues raised in the above-captioned case, in the Supreme
Court, in the Court of Appeals, nor the different Divisions thereof, nor in any other court
or tribunal or agency and, to the best of my knowledge, no such other action or claim is
pending therein;
4. I hereby undertake to notify this Honorable Court of such fact within five (5) days from
receipt of such knowledge, should I come to learn that the same or a similar action or
claim has been filed or pending in the Supreme Court, Court of Appeals, the different
Divisions thereof, or any other court or tribunal or agency;
5. I am executing this sworn statement in compliance with Section 5, Rule 7 of the
1997Rules of Court.

ADRIAN GABRIEL S. ATIENZA

Affiant
 ACKNOWLEDGMENT

On this 17th day of JUNE 2022, personally appeared before me the above-named
ADRIAN GABRIEL S. ATIENZA known to me to be the person who executed the foregoing
application and made oath that the statements therein are true of their knowledge, information
and belief.

The affiant exhibited to me his Tax Identification Card, with TIN No. 8-7000-0000
issued at Bureau of Internal Revenue, Manila dated November 11, 2019 as competent evidence
of his identity, and he personally acknowledged to me that the foregoing “Petition” is his free
and voluntary act and deed. Machine copy of this TIN Card ID is hereto attached.

ATTY. LUIS MIGUEL S. ATIENZA

Notary Public
PTR No. 20202111,
IBP OR No. 654321,
Attorney’s Roll No. 11122
MCLE Compliance Certificate No. IV-0025415,
Pasig City, 1/2/17
Doc No. _____;

Page No. _____;

Book No. _____;

Series of 2022.