REPUBLIC OF THE PHILIPPINES )

_____________________________ ) S.S.

AFFIDAVIT OF RECONCILIATION
-------------------------------

I, LEA REDDIQUE SERENIO, of legal age, Filipino and a resident of Poruk 6, Garzota Street,
Buenavista, Santiago City,Isabela after being duly sworn hereby depose and state as follows:

That I discovered that my encoded name in my Certificate of Marriage is LEAH

REDDIQUE SERENIO instead of my true, correct and registered name LEA REDDIQUE
SERENIO;

That my true and correct name is LEA REDDIQUE SERENIO, as evidenced by my

Certificate of Live Birth, is hereto attached as Annex A and made integral part hereof;

That in my Government/Private issued Identification Cards (IDs), records, and

public/private representations, I used the name LEA REDDIQUE SERENIO, my true, correct
and registered name. A a copy of my Unified Multi-Purpose ID bearing my true and correct
name “LEA” is hereto attached as Annex B and made integral part hereof;

That the names LEA REDDIQUE SERENIO and LEAH REDDIQUE SERENIO refer to
one and the same person, the undersigned affiant;

That I execute this Affidavit of Discrepancy to attest to the truthfulness of all the foregoing
statements/circumstances and for the purpose of securing my PASSPORT.

IN WITNESS WHEREOF, I have hereunto set my hand in signature, this __th day of December
2019 at _______________, Philippines.

HAYDEE B. PANGILINAN
Affiant

SUBSCRIBED AND SWORN TO before me, a Notary Public for and in ______________, by
the above-named affiant exhibiting her _____________________________, this _th day of
October 2011 at ____________, Philippines.

NOTARY PUBLIC
Doc. No._______;
Page No. ____;
Book No.______;
Series of 2011.