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Republic of the Philippines

REGIONAL TRIAL COURT

DESIGNATED FAMILY COURT

Sixth Judicial Region

Branch___, Kalibo, Aklan

IN THE MATTER OF THE ADOPTION Sp. Proc. Case No.___

OF THE MINOR MARY ANN LAGUNBAY,

SPOUSES LEWIS MORTALLA AND

SALVADORA TORTUYA MORTALLA,

Petitioners.

x-----------------------------x

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, Aklan, 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, Aklan, 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, Aklan;

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;

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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, 2011.

ATTY. HENNESSY KESHIA T. MATIONG

Counsel for the Plaintiff

N. Tesorero St., Poblacion, Makato, AklanIBP No. 5678* Kalibo, Aklan* 27 Sept. 2013

PTR No.9101112 *Kalibo, Aklan*28 Sept. 2013

Roll of Atty. No.11281988*Page496* BookX11MCLE Compliance Exempted

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, Aklan, 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 ourpersonal 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,

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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 17 th day of March 2012,

Makato, Aklan, Philippines.

LEWIS MORTALLA SALVADORA T. MORTALLA

Affiant Affiant

SUBSCIBED AND SWORN TO before me this 17th day of March 2012, in the

Municipality of Makato after petitioners SPOUSES LEWIS MORTALLA and

SALVADORA T. MORTALLA showed to me their Drivers Licenses numbered 1234567

and 7654321 respectively, issued on January 6, 2011 and issued in Kalibo, Aklan.

ATTY. HENNESSY KESHIA T. MATIONG

Notary PublicN. Tesorero St., Poblacion, Makato, Aklan

IBP No. 5678* Kalibo, Aklan* 27 Sept. 2013

PTR No.9101112 *Kalibo, Aklan*28 Sept. 2013Roll of Atty. No.11281988* Page496*BookX11

MCLE Compliance Exempted

Commission No. 1234* Until Dec. 31, 2012

Doc. No. ;

Page No. ;Book No. ;

Series of 2012