REPUBLIC OF THE PHILIPPINES)

) S.S.

AFFIDAVIT

I, MARK ANTHONY C. MINGLANA, of legal age, Filipino, with office address at Sitio Payong,
Barangay Dalig, Antipolo City, after having been duly sworn on in accordance with law, depose and state
that:

1. When I signed my Voters Identification Card (ID) issued by the Commission on Election,
City of Antipolo, I was using the following specimen signature:

_______________________________________
Old Specimen Signature

2. That in the year 2017, I changed my specimen signature such that in the PhilHealth ID, my
specimen signature is as follows:

_______________________________________
Old Specimen Signature

3. That in the year 2018, I changed my specimen signature such that in the Company ID, my
specimen signature is as follows:

_______________________________________
New Specimen Signature

4. When I signed my application for Multi-Purpose Loan at Pag-Ibig Fund, I was still using
the following specimen signature, which is the same as my signature in my Company ID:

_______________________________________
New Specimen Signature

5. I am executing this Affidavit to explain the discrepancy of my old and new specimen
signatures as my old specimen signature appear in my Voters and PhilHealth ID and that my new specimen
signature appears in my Company ID, and for whatever legal purpose and intent it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this_______ day of

_____________ at _____________.

MARK ANTHONY C. MINGLANA

Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of __________ at ______________,

Philippines by affiant who presented his Voter’s ID No. 5802-0474I-B0492MCM1000.

Doc. No. _________;

Page No. _________;
Book No. _________;
Series of 2019.