Republic of the Philippines )

Province of Agusan del Sur ) S.S.

AFFIDAVIT OF DISCREPANCY

I, ESTERIA BURATO DOLOYAN, of legal age, single, Filipino and resident of Purok
22, Poblacion, Prosperidad, Agusan del Sur, under oath declare:

1. That I was born on August 9, 1971 in Alicia, Bohol to the spouses Jose Dulogan and
Sixta Jotojot Burato;

2. That since childhood, I am known by the name ESTERIA BURATO DOLOYAN

which I have been using in all my personal records, transactions and communications. A
copy of my Transcript of Record, Professional Regulatory Commission (PRC), GSIS
UMID-ID and PAGIBIG ID are hereto attached as ANNEXES "A", “B”, “C”, and “D”,
respectively;

3. That the surname appearing on my Certificate of Live Birth registered with the Civil
Registry of Alicia Bohol is "DOLOYAN"

4. However, the my surname appearing in the National Statistics Office is "DULOYAN".

A copy of my Certificate of Live Birth issued by the Civil Registry of Aurora, Quezon
and the National Statistics Office are hereto attached as ANNEXES “E” and “F”,
respectively;

5. When I applied for a Philippine passport in the Department of Foreign Affairs (DFA) the
personnel advised me to have the discrepancy in my surname corrected so that they can
start process said passport application;

6. That since it will be easier to correct one document which is the Certificate of my Live
Birth, I am executing this affidavit to rectify my name on said document and change
surname from "DULOYAN" to "DOLOYAN";

7. That this affidavit is further executed to attest to the truth of the foregoing facts and for
all intents this might be of legal worth;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 22nd day of August,
2019 in Poblacion, Prosperidad, Agusan del Sur, Philippines.

ESTERIA BURATO DOLOYAN

Affiant

SUBSCRIBED AND SWORN to before me, in Poblacion, Prosperidad, Agusan del Sur,
Philippines, this 22nd day of August, 2019, the affiant exhibiting her competent proof of identity,
and personally known to me to be the same person executing this affidavit..