REPUBLIC OF THE PHILIPPINES

Republic of the Philippines

REGIONAL TRIAL COURT

DESIGNATED FAMILY COURT

Sixth Judicial Region

Branch___, Iloilo City IN THE MATTER OF THE ADOPTION

Sp. Proc. Case No.___

OF THE MINOR MARY ANN LAGUNBAY,

SPOUSES LEWIS MORTALLA AND

SALVADORA TORTUYA MORTALLA,

Petitioners.

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PETITIONERS, through counsel, before this Honorable Court most respectfully state:

1. That petitioners are lawful husband and wife, of legal ages, Filipino citizens, and with postal address at McKinley St., Poblacion, Makato, Iloilo City, where they may be served with summons and other court processes;

2. That the said spouses desire to adopt minor child, Mary Ann Lagunbay, six (6) years of age, who was born in Tibiawan, Makato, Iloilo City, on December 10, 2005. Herewith as Annex A is a photostatic copy of the certificate of live birth of the minor child, Mary Ann Lagunbay, and is made integral part hereof;

3. That the father of the child is unknown being the illegitimate son of Marites G. Lagunbay, Filipino, of legal age, single, and is residing at Tibiawan, Makato, Iloilo City;

4. That Marites G. Lagunbay has consented to the adoption of the minor child, Mary Ann Lagunbay, as shown by an instrument executed and signed by her, a copy of which is attached to this petition as Annex B and made an integral part hereof;

5. That the herein petitioners would like to give the minor child good education and a secured future and to erase the stigma of his illegitimacy;

6. That herein petitioners, especially Salvadora T. Mortalla, have known the minor child from birth and have developed a kind of parental love and care for the child;

7. That herein petitioners are childless and can very well support and can provide education to the minor child Mary Ann Lagunbay;

8. That this adoption will serve the best interests and well-being of the minor child Mary Ann Lagunbay.

PRAYER

WHEREFORE, it is most respectfully prayed that this Honorable Court, after due notice, publication and hearing, would render judgment to the effect that henceforth, the minor child Mary Ann Lagunbay be free from all legal obligations of obedience and maintenance with respect to his natural parent, and be, to all legal intents and purposes, the child of the petitioners, and that the surname of the child of the petitioners, and that the surname of the child of the petitioners, and that the surname of the child be changed to Mary Ann Tortuya Mortalla, which is the surname of the petitioners.

Petitioners likewise pray for such other and further relief or reliefs as this Honorable Court may deem proper and just in the premises.

Iloilo City, February 17, 2016.

ATTY. JOSE MARIA BORROMEO DELA LLANA

Notary Public Iloilo City

Appointment No. M-308 Until December 31, 2017

Roll No. 020381PTR No. 10064532, 1-20-12

IBP No. 989977, 1-23-12

Office BORROMEO Bldg.Gen. Luna St., Iloilo City

VERIFICATION AND CERTIFICATE AGAINST NON-FORUM SHOPPING

We, spouses Lewis Mortalla and Salvadora Tortuya Mortalla , of legal age, Filipino and a resident of McKinley St., Poblacion, Makato, Iloilo City, after having been sworn to in accordance with the law, hereby depose and say that:

1. We are the petitioners in this instant petition;

2. We caused the personal preparation of the foregoing petition;

3. We have read the same and the contents thereof are true and correct of our personal knowledge;

4. That we have not theretofore commenced any action or proceeding involving the same issues in the Supreme Court, the Court of Appeals, or any tribunal action or proceeding is pending in the above-stated Courts or to any other tribunal or agency; that if there is any other action or proceeding which is either pending or may have been terminated other than the above-mentioned, we must state the status thereof; and that if we should thereafter learn that a similar action or proceeding has been filed or is pending before the Supreme Court, the Court of Appeals, or any other tribunal or agency, we undertake to report the same within five (5) days therefrom to the court or agency wherein the original pleading and sworn certificate contemplated herein have been filed.

IN WITNESS THEREOF, we hereby affix our signatures this 17th day of February 2016, Makato, Iloilo City, Philippines.

LEWIS MORTALLA

SALVADORA T. MORTALLA

Affiant

Affiant

SUBSCIBED AND SWORN TO before me this 17th day of February 2016, in the City Of Iloilo after petitioners SPOUSES LEWIS MORTALLA and SALVADORA T. MORTALLA showed to me their Drivers Licenses numbered 1234567 and 7654321 respectively, issued on January 6, 2016 and issued in Iloilo City.

ATTY. JOSE MARIA BORROMEO DELA LLANA

Notary Public Iloilo City

Appointment No. M-308Until December 31, 2017

Roll No. 020381PTR No. 10064532, 1-20-12

IBP No. 989977, 1-23-12Office BORROMEO Bldg., Gen. Luna St., Iloilo City

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