Republic of the Philippines

REGIONAL TRIAL COURT

DESIGNATED FAMILY COURT
Sixth Judicial Region
Branch___, Iloilo City

IN THE MATTER OF THE ADOPTION

OF THE MINOR MARY ANN LAGUNBAY,

Sp. Proc. Case No.___

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, 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. 020381 PTR 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.
2.
3.
4.

We are the petitioners in this instant petition;

We caused the personal preparation of the foregoing petition;
We have read the same and the contents thereof are true and
correct of our personal knowledge;
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 17 th day of

February 2016, Makato, Iloilo City, Philippines.

LEWIS MORTALLA
Affiant

SALVADORA T. MORTALLA
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-308
Until December 31, 2017
Roll No. 020381
PTR No. 10064532, 1-20-12
IBP No. 989977, 1-23-12
Office BORROMEO Bldg., Gen. Luna St., Iloilo City
Doc. No.
;
Page No.
;
Book No.
;
Series of 2012