Republic of the Philippines

REGIONAL TRIAL COURT

Fifth Judicial Region
Branch ____________
Naga City

_____________________,

Petitioner

-versus- CIVIL CASE No: __________

____________________,

Respondent

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

PETITION FOR LEGAL SEPARATION

NOW COMES the petitioner, by the undersigned counsel, and unto this Honorable Court,
respectfully alleges:

1. That the petitioner is a resident of ____________, for the last __________ years;
2. That the petitioner and the respondent were legally married in ______________ on
___________ .
3. That out of the said marriage, ____ children were born, to wit;
4. That during said marriage, the following real properties had been acquired:
5. That on or about ________,20_______, the respondent committed an act
of__________
6. That the petitioner has never condoned or committed such act of infidelity on the part
of the respondent;
7. That the petitioner bacame cognizant of the above cause on _________20___ or
within one year up to the filing of this petition and within five years from and after
the date when such cause occured;
8. That the facts of this case renders the reconciliation of parties highly improbable.

WHEREFORE, it is respectfully prayed:

(a) That pending these legal separation proceedings, the respondent be deprived of
his right to manage the conjugal partnership and that adequate provision be made
out of the conjugal property.
(b) That after due hearing, a decree of legal separation be issued by this honorable
court ordering:
(1) That the petitioner be entitled to live separately from the respondent,
without dissolution , however, of the marriage bond;
(2) That the conjugal partnership be dissoved and liquidated, dividing
equal share for the petitioner and the respondent all conjugal properties
and conjugal partnership profits
(c) That such other relief or remedy be granted to the petitioner as may be just and
equitable.
 VERIFICATION

I,_________, Filipino, of legal age, single and a resident of P7 San Francisco,

Guinobatan, Albay, after being duly sworn to in accordance with law hereby state:

1. That I am the petitioner of the above instant case;

2. That I have caused the preparation of the above-entitled petition;

3. That I have read the same and that it is true and correct based on my
personal knowledge or based on authentic records;

4. That I hereby certify under oath in this petition as follows;

5. I have not theretofore commenced any action or filed any action or claim
involving the same issue in any court, tribunal or quasi-judicial agency and, to the best
of my knowledge, no such other pending action or claim is pending therein;

6. If there is such other pending action or claim, a complete statement of the

present status thereof; and

7. If I should thereafter learn that the same or similar action or claim has
been filed or is pending, I shall report that fact within five (5) days therefrom to the
court wherein the aforesaid complaint or initiatory pleading has been filed.

IN WITNESS WHEREOF, I have hereunto affixed my signature this , Cebu City,

Philippines.

_____________________________
TIN: 421-754367

SUSBCRIBED AND SWORN TO before me, a notary in the Province and City of
Legazpi, personally appeared above name with hers Tax Identification Number as
shown above, who is personally known to me to be the same and/ or identified through
competent evidence of identity as defined by Rules on Notarial Practice, who presented
the foregoing instrument and signed the instrument in my presence, and who took an
oath before me as to such instrument.

Witness my hand and seal this _____________________________

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