3

Republic of the Philippines)

Province of Benguet )S.S.
City of Baguio )

AFFIDAVIT OF SUPPLEMENTAL REPORT

I, Anthony Dan S. Ogbinar, Filipino, of legal age, married and resident of

#126 Jupiter St. Dreamland Subdivision, Barangay Namayan,
Mandaluyong City, Province of Rizal, Philippines, having been duly sworn
in accordance with law, hereby depose and state:

That I was born on September 24, 1957 in Baguio City, Province of

Benguet, to the Spouses Romeo R. Ogbinar Sr. and Teodora S. Ogbinar;

That since I was young, I have always been known and called by the first
name "Anthony Dan" and that it is the same first name that I have been
using in all my documents and identification papers;

However, it appears from the records of the Office of the Civil

Registrar of Baguio City that I was registered therein without a given first
name;

That it is my desire to be registered with the said Office of the Civil

Registrar of Baguio City with the first name "Anthony Dan;"

That the failure to state my first name was purely the inadvertence of my
parents who failed to do so because of their uncertainty at first as to what
name would be given me at the time of the registration of the facts of my
birth with the said office;

As such, I execute this Affidavit to certify or attest to the truth of the

foregoing facts and for whatever legal purpose that this Affidavit may
serve.

IN WITNESS WHEREOF, I have set my hands this 23rd March 2018, in the
City of Baguio, Philippines.
ANTHONY DAN S. OGBINAR
Affiant

ACKNOWLEDGEMENT

SUBSCRIBED AND SWORN to before me, this 23rd day of March 2018, by
ANTHONY DAN S. OGBINAR who exhibited to me his Identification card
No. _____________ issued at _____________ on _____________

Notary Public

Doc. No. ______;

Page No. ______;

Book No. ______;

Series of 2018