REPUBLIC OF THE PHILIPPINES

11th Judicial Region

REGIONAL TRIAL COURT
Branch 34
Panabo City, Davao del Norte

IN THE MATTER OF THE

PETITION TO CORRECT
ENTRIES IN THE CERTIFICATE
OF LIVE BIRTH OF JULIETA Q.
BONGATO, TO WIT:
SP. PROC. NO. SPC-20-2017

A. YEAR OF BIRTH FROM

NO ENTRY TO FEBRUARY
4, 1957; and
B. SURNAME FROM
BUNGATO to BONGATO

JULIETA Q. BONGATO,

Petitioner,

- versus

THE OFFICE OF THE CITY CIVIL

REGISTRAR
OF DAVAO DEL NORTE

Respondent,

X-------------------------------x

JUDICIAL AFFIDAVIT OF
JULIETA Q. BONGATO

I, JULIETA Q. BONGATO of legal age, single, and living at Purok 7,

Salvacion, Panabo City, Davao del Norte, petitioner in this case, state under
oath as follows:

I am answering the questions asked of me by Atty. Joahna Paula Q.

Domingo, fully conscious and aware that the same is under oath and that I
may face criminal liability for false testimony and perjury.
 OFFER OF TESTIMONY

This affidavit/testimony of petitioner JULIETA Q. BONGATO is being

offered to prove that her LAST NAME, BONGATO was erroneously
registered as BUNGATO. In addition, no date of birth was entered on
petitioners Certificate of Liver Birth, as registered. The petitioners
testimony is also offered to cause the Local Civil Registrar of Panabo City to
make the correction of her erroneous last name and to register the entry of
her birth date.

1. Q. Unsa imong kumpleto nga pangalan, edad ug as aka nagpuyo?

(Please state your name, age and address for the record.)
A: Ako si JULIETA Q. BONGATO, 60 years old, Purok 7, Salvacion,
Panabo City, Davao del Norte
(I am JULIETA Q. BONGATO, 60 years old, Purok 7, Salvacion,
Panabo City, Davao del Norte)

2. Q. Ikaw ba ang pareho nga JULIETA aning nga kaso nga naay Case No.
SPC 20-2017?
(Are you the same JULIETA, the petitioner in this case?)
A: Oo maam ako.
(Yes maam it is me.)

3. Q. Naa kay ebidensya nga ang pagkapanganak kanimo nakarehistro sa

Local Civil Registrar?
(Do you have any proof that your birth is being registered in Local Civil
Registrar?)
A: Oo maam ang Authenticated Certificate of Live Birth nga gikan sa
Philippine Statistices Authority (PSA). (Annex E)
(Yes maam. The Authenticated Certificate of Live Birth, issued by the
Philippine Statistices Authority (PSA). (Annex E))

4. Q: Tama ba ang mga impormasyon nganakabutang sa imong Certificate

of Live birth?
(Are the information in your Certificate of Live birth correct?)

A: Dili Maam.

(No Maam.)
5. Q: Unsa ang particular nga mga impormasyon sa imong certificate of live
birth ang sayop nga pagkarehistro?
(What particular information in your live birth was erroneously
registered?)

A: Ang spelling sa akong apelyido mali nga BUNGATO kay ang tama nga
spelling, BONGATO, ug ang petsa sa akong pagkatawo wala nakabutang
sa akong certificate of live birth. Gipanganako ko kaniadtong February 4,
1957.

(The spelling of my family name was misspelled as BUNGATO instead of

BONGATO and my certificate of live birth does not contain my birth date.
I was born on February 4, 1957.)

6: Q: Unsay imong ebidensya nga mao na ang tama nga spelling sa imong
apelyido?

(What is your proof of the correct spelling of your family name?)

A: Ang death certificate sa akong inahan (Annex A) ug amahan (Annex

B).

(The death certificate of my mother (Annex A) and father (Annex B).

7. Q: Unsay imong ebidensya nga natawo ka kaniadtong February 4, 1957?

(What is your evidence that you were born on February 4, 1957?)

A: Ang akong mga SSS I.D., Comelec I.D. nga naay adlaw sa akong
natawhan nga 36 ka tuig na nako ginagamit sukad nagsugod ko ug
trabaho.
(My SSS and COMELEC identification cards reflecting my dates of birth
that I have been using for 36 years since I started working.)

8. Q: Unsay epekto ni-aning mga mali nga impormasyon sa imoha?

(What are the effects of this erroneous information to you?)

A: Ang sayop sa spelling sa akong apelyido nakaapekto sa akong pag-

claim sa akong retirement benefits tungod kay mali ang spelling sa akong
apelyido ug wala pud koy petsa sa adlaw nga akong natawhan sa
Certificate of Live Birth gikan sa Philippine Statistics Authority, nga usa sa
mga requirements para maka-claim ko sa akong mga benepisyo sa
retirement sa SSS.
 (Such discrepancy affects my personal data in my Certificate of Live Birth
issued by the Philippine Statistics Authority, which is one of the
requirements for me to be able to claim my retirement benefits from
SSS.)

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day

of November 2017 at Panabo City, Davao Del Norte.

JULIETA Q. BONGATO
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of

November, in Panabo City, Davao del Norte, Philippines.

SWORN ATTESTATION/CERTIFICATION

I, ATTY. JOAHNA PAULA Q. DOMINGO, am the handling

lawyer of the above-captioned case with office address at Public
Attorneys Office, Hall of Justice, Panabo City, Davao del Norte. I
am the one who conducted the examination of the witness and
the same was conducted at the Public Attorneys Office, Hall of
Justice, Panabo Davao del Norte on 10 November 2017. I also
certify that:
1. I faithfully recorded or caused to be recorded the questions
I asked from Ms. Juliet Q. Bongato and the corresponding
answers that the said witness gave; and

2. Neither I nor any other person then present on 10

November 2017 coached Ms. Juliet Q. Bongato regarding
the latters answers.

IN WITNESS WHEREOF, I have hereunto set my hand this

10 day of November 2017 in Panabo City, Davao del Norte,
th

Philippines.

ATTY. JOAHNA PAULA Q. DOMINGO

Affiant
Competent Evidence of Identity: Roll No. 67043
TIN 234-816-600-000
 SUBSCRIBED AND SWORN to before me this 10th day of
November 2017 in Panabo City, Davao del Norte, Philippines by
the affidavit with her above-indicated competent evidence of
identity.

Copy furnished:
PANABO CITY PROSECUTIONS OFFICE
Panabo City, Davao del Norte