Sample Petition For Correction

 

RA 9048 Form No. 2.1 (LCRO) (Devised 15 Aug. 2001) SAML! R!"#L$C OF %&! &$L$$N!S LOCAL C$'$L R!$S%R OFF$C! rovi*+e o, -*g-si*-*   C$% OF ALAM$NOS Re/ui+ o, 3e 3ii//i*es )  rovi*+e o, -*g-si*-* )  Ci o, A-mi*os )  ) SS eiio* No.  !%$%$ON FOR CORR!C%$ON OF CL!R$CAL !RROR $N %&! C!R%$F$CA%! OF MARR$A! or #$R%& OR D!A%& $6 6 o, eg- -ge6 6 (+om/ee *-me o, /eiio*er) (*-io*-i7+iie*s3i/) -*d - reside* o,       (+om/ee -ddress) -,er 3-vi*g ee* du sor* o i* -++ord-*+e i3 -6 3ere de+-re 3-: 1. $ -m - /eiio*er see;i*g +orre+io* o, 3e +eri+- error i*: -) m Ceri,i+-e o, M-rri-ge e*ered i*o i3      (+om/ee *-me o, s/ouse) ) 3e Ceri,i+-e o, M-rri-ge o*  (+om/ee *-me o, 3us-*d or i,e) 3o is m  (re-io* o, o*er o 3e /eiio*er) 2. $7&e7S3e -s or* o*  -  (d-e o, m-rri-ge) (+i7mu*i+i/-i)   6 .  6  . (/rovi*+e) (+ou*r)