RA 9048 Form No. 1.

1 (LCRO)

Republic of the Philippines

Local Civil Registry Office
Province: Cebu
Municipality: Cebu City

Republic of the Philippines ) Petition No.: ________________

Cebu City ) SS

PETITION FOR CORRECTION OF CLERICAL ERROR IN THE

CERTIFICATE OF LIVE BIRTH

I, of legal age, Filipino, and a resident of Looc, Mandaue City, after having been sworn to
in accordance with law, hereby declare that:
1) I am the petitioner seeking the correction of entry in:
a) Certificate of Live Birth of my son,
2) My son was born on.

3) The birth was recorded under registry number

4) The clerical error(s) to be corrected is/are (use additional sheets, if necessary)

ITEM NO. DESCRIPTION FROM TO
1
6

5) The facts/reasons for filing this petition are the following: (use additional sheets if
necessary)
To correct the erroneous entry to coincide with my son’s other documents.

6) I submit the following documents to support this petition: (use additional sheets if
necessary)
a) Copy of Certificate of Live Birth
b) Copy of Certificate of Live Birth of Mother

7) I have not filed any similar petition and that to the best of my knowledge, no other similar
petition is pending with any LCRO or Court of the Philippine Consulate.

8) I am filing this petition at the LCRO of Cebu City, Province of Cebu in accordance with
RA 9048 and its implementing rules and regulations

___________________
Signature over Printed Name

1
 VERIFICATION

I, , under oath, states:

1. I am the petitioner
2. I have caused the preparation of this petition
3. I have read the petition and all the facts stated here are true and correct to the best of my
personal knowledge and based on authentic records.

IN WITNESS WHEREOF, I have affixed my signature this 17th day of February, 2019
at Mandaue City, Cebu, Philippines.

________________________
Signature over printed name
SUBSCRIBED AND SWORN to before me this 17 th day of February, 2019 at Mandaue
City, Cebu, Philippines, petitioner exhibited to me his _______________________________ as
proof of identity.

________________________
Administering Office
Doc No.: ____
Page No.: ____
Book No.: ____
Series of: ______

For C/MCR use only

ACTION TAKEN BY THE C/MCR

Granted Denied (Provide basis for denial)

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________________________.

Date: ________ ________________________

City/Municipal Civil Registrar

2
For CRG use only

ACTION TAKEN BY THE CRG

Affirmed Impugned

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________.

Date: ____________ _______________________

City Registrar General

OR No.: _________________________
Amount Paid: _____________________
Date Paid: ________________________