Republic of the Philippines

REGIONAL TRIAL COURT

FIRST JUDICIAL REGION
Branch 8
Baguio City

IN RE: PETITION FOR CHANGE OF NAME

FROM “RICKY PATAYAN” TO
“RICKY NAPU PUCAN”

Special Proceedings
Case No.12345
For: CHANGE OF NAME

RICKY PUCAN PATAYAN

Petitioner.
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PETITION FOR CHANGE OF NAME

Petitioner, through the undersigned counsel and unto this Honorable Court, most
respectfully avers that:

1. Petitioner is of legal age, single, Filipino and a resident of #74 Rimando Road,
Aurora Hill, Baguio City, Philippines where notices and other court processes
may be served;

2. Petitioner seeks the change of his name in his Certificate of Live Birth (Copy of
which is hereto attached as ANNEX “A”, to make an integral part hereof.);

3. Petitioner was born in Manabo, Abra, Philippines on November 25, 1981 as the
eldest child of Spouses RONALDO PATAYAN and ANN P. PATAYAN;

4. Petitioner’s Certificate of Live Birth bears Registry No. 9801, and duly registered
on November 28, 1981;

5. His name is to be changed is from “RICKY PUCAN PATAYAN” to “RICKY

NAPU PUCAN”;

6. The ground for filing this petition is to remove confusion as to his scholastic
records and other legal effects and my first name appearing on my Certificate of
Live Birth;

7. His name is always subject to ridicule and even to threats especially at their
place in Manabo, Abra where they are associated with the infamous former
governor;

8. Petitioner a submitting the following documents to support this petition;

a) Elementary, Secondary and College Diplomas

b) Social Security System ID

c) Tax Identification

d) Affidavit of Two Disinterested Persons

 e) Voter’s ID

f) Governmental and Non-governmental Organization Membership

ID’s

9. Petitioner also have no pending administrative, criminal, or civil case in any court
of law or quasi-judicial body; and

10. Petitioner is filing this petition in accordance with Rule 103 of the Rules of
Court.

PRAY E R

WHEREFORE, premises considered, it is respectfully prayed of the Honorable Court that

upon due hearing, an order be issued:

1. declaring that RICKY PUCAN PATAYAN be changed to RICKY NAPU PUCAN;

2. ordering the Municipal Registry Office of Manabo, Abra to make the necessary
changes in their records in the Certificate of Live Birth of Farland Dao-ayan Valera.

Such other reliefs just and equitable are likewise prayed for.

Baguio City, Philippines, February 21, 2014.

ATTY. JOSELITO AGBUGGO

Counsel for Petitioner
3D La Azotea Bldg., Session Road,
Baguio City
Tel No.: (074)-442-3396
PTR No. 99999; 1/07/2014; Baguio City
IBP OR No: 6298647; 1/07/2014; Baguio City
Roll No.: 88888; 4/08/2003
MCLE Compliance No.: IV-34458; 04/28/2012

Republic of the Philippines )

Done in the City of Baguio ) SS.
x------------------------------------x

VERIFICATION AND CERTIFICATION

AGAINST FORUM SHOPPING

I, RICKY P. PATAYAN, of legal age, Filipino and a resident f #66 Tabora, Baguio City,
Philippines, after having been sworn to in accordance with law, do hereby depose and say:

1. That I am the petitioner in the above-entitled case;

2. That I have caused the preparation and filing of this petition for change of
name; and,

3. That I have read the material and relevant allegations therein contained and the
same are true and correct based on my personal knowledge and authentic
records.
 Further, I certify:

1. That I have not heretofore commenced any action or filed any claim involving
the same issues before any other court, tribunal or quasi-judicial agency; that to
the best of my knowledge, there is no such pending action or claim and that if I
should hereafter learn that the same or similar action or claim has been filed or is
pending, I shall report such fact within five (5) days there from to the Honorable
Court.

IN WITNESS WHEREOF, I have hereunto affix my signature this 1 st day of February

2014, in the City of Baguio, Philippines.

RICKY P. PATAYAN
Affiant

SUBSCRIBED AND SWORN to before me in the City of Baguio this 1st day of February
2014 by RICKY P. PATAYAN, personally known to me, to be the same person who personally
signed before me the foregoing and acknowledged that he executed the same.

JO-ANNE M. VENTIGAN
Notary Public for Baguio City
Until December 31, 2014
4F La Azotea Bldg., Session Road, Baguio City
Tel No.: (074)-442-3396
PTR No. 22222; 1/07/2012; Baguio City
IBP OR No: 7654321; 1/07/2012; Baguio City
Roll No.: 82112; 4/08/2004
Commission No.: 74-NC-12 (R)
MCLE Compliance No.: IV-34458; 04/28/2012
TIN No: 802-112-107