Change of First Name

Republic of the Philippines
Office of the City Civil Registrar

Kanhuraw Hill, City Hall Annex Bldg., Tacloban City
Telephone No.: (053) 523-5948
SUPPORTING PAPERS FOR CORRECTION OF CLERICAL OR

TYPOGRAPHICAL ERROR AND/OR CHANGE OF FIRST NAME:
ERROR to
to
 Certified machine copy of the certification containing the alleged
erroneous entry of entries.
 Baptismal Certificate
 Voter’s Affidavit/Certification
 GSIS Record
 SSS Record
 Medical Record
 Business Record
 School Record (DECSS Form 137)
 Driver’s License
 Insurance
 Civil Registry Records of Ascendants
-Marriage Contract
-Birth Certificate
 Certificate of Land Titles
 Bank Passbook
 NBI Clearance
 PNP Clearance
 Employment Clearance (If employed)
 Affidavit of Two (2) Disinterested Persons
 Barangay Certificate
 Birth Certificate
 Other
s:
THE SUPPORTING DOCUMENTS MUST BE SUBMITTED IN FOUR (4) COPIES DULY

CERTIFIED BY ISSUING OFFICE:
Filling Fee : P PLEASE SUBMIT :

Publication Fee : P 4 pcs. Long Folder
Mailing Fee : P 4 pcs. Paper Fasteners
Service Migrant : P
TOTAL : P
RA 9048 Form No. 4.1. (LCRO)
(Devised 10 Aug. 2011)
Republic of the Philippines

Local Civil Registry Office
Province: Abra
City/Municipality: Villaviciosa
Republic of the Philippines )

Villaviciosa, Abra ) SS Petition No.
PETITION FOR CHANGE OF FIRST NAME
I, Nicky Ronald A. Cadalig of legal age, Filipino ,

(Complete name of petitioner) (Nationality/Citizenship)
and a resident of 321A Pag-asa St., Kaybagal North ,
Crisanto M. Delos Reyes Ave., Tagaytay City
Cavite, Philippines 4100
(Complete address)
after been having duly sworn to in accordance with law, hereby declare that:
1) I am the petitioner seeking the change of first name in:

a) my Certificate of Live Birth
b) The Certificate of Live Birth of
(Complete name of owner)
who is my .
(Relation of owner to the petitioner)
2) I/He/She was born on March 27, 1973 at Villaviciosa,

(Date of Birth) (City/Municipality)
Abra , Philippines.
(Province) (Country)
3) The birth was recorded under registry number 5 (d-73).
4) The first name to be changed is from Ronald to Nicky Ronald.
5) The grounds for filling this petition are the following:
a) The first name is extremely difficult to write or pronounce;
b) I have/He/She has habitually and continuously used Nicky Ronald
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 is ridiculous;
e) The first name causes confusion;
f) Others: (Specify)
6) I submit the following documents to support this petition: (Use additional sheets, if necessary.)
a) PSA Copy of Birth Certificate
b) PSA Copy of Marriage Contract
c) Police Clearance
d) NBi Clearance
e) Employment Clearance
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, Court of Philippine Consulate.
8) I am filing this petition at the LCRO of Villaviciosa , Abra
(City/Municipality) (Province)
in accordance with R.A. No. 9048 and its implementing rules and regulations.
Signature Over Printer Name of Petitioner

VERIFICATION
I, Nicky Ronald A. Cadalig , the petitioner, hereby certify that the allegations
Herein are true and correct to the best of my knowledge and belief.
Nicky Ronald A. Cadalig

Signature over Printed Name of Petitioner
SUBSCRIBED AND SWORN to before me this day of

in the city/municipality of , petitioner exhibiting his Community Tax Certificate
No. issued at on .
Administering Office
Doc. No. ___________

Page No. ___________
Book No. ___________
Series of ___________
___________________________________________________________________________________
For C/MCR use only
ACTION TAKEN BY THE C/MCR
Granted Denied (Provide the basis for denial.)
Date:
City/Municipality Civil Registrar
_____________________________________________________________________________________
For CRG use only
ACTION TAKEN BY CRG
Affirmed Impugned
Date:
City Registrar General
CBL/11Aug01
O.R. No.:
Amount Paid:
Date Paid:

Change of First Name

Uploaded by

Change of First Name

Uploaded by

Republic of the Philippines

Office of the City Civil Registrar

SUPPORTING PAPERS FOR CORRECTION OF CLERICAL OR

THE SUPPORTING DOCUMENTS MUST BE SUBMITTED IN FOUR (4) COPIES DULY

Filling Fee : P PLEASE SUBMIT :

Republic of the Philippines

Republic of the Philippines )

PETITION FOR CHANGE OF FIRST NAME

I, Nicky Ronald A. Cadalig of legal age, Filipino ,

1) I am the petitioner seeking the change of first name in:

2) I/He/She was born on March 27, 1973 at Villaviciosa,

Signature Over Printer Name of Petitioner

Nicky Ronald A. Cadalig

SUBSCRIBED AND SWORN to before me this day of

Doc. No. ___________

For C/MCR use only

ACTION TAKEN BY THE C/MCR

Granted Denied (Provide the basis for denial.)

For CRG use only

ACTION TAKEN BY CRG

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