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Affidavit Attesting To One and The Same Person (111113)
Affidavit Attesting To One and The Same Person (111113)
1. I was born on 3 June 1960 at Espana, Manila and that my father, Lucio Rios
Carino, and my mother, Lourdes Rosales Mores, registered me as Maria Elena Cleotilde
Mores Carino as stated in a certified true National Statistics Office (NSO) copy of my
Birth Certificate;1
2. I got married to Domingo Paulino. Since then, I used the name MARIA
ELENA CLEOTILDE C. PAULINO to reflect my married status;
7. I am affirming to the truth of the facts as reflected in the foregoing and have
related the circumstances why there is an apparent conflict in what appears to be my
name in my Certificate of Live Birth and in some of my official records;
_________________________________
MARIA ELENA CLEOTILDE C. PAULINO
Affiant
1
Attached as Annex “A” is a copy of my Birth Certificate.
2
Attached as Annexes “B” and “C” are copies of my Passport and Driver’s License.
1
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2013,
in Quezon City, Philippines, affiant personally exhibiting to me her
________________ issued on _____________.
Notary Public
Doc. No._____
Page No._____
Book No. ____
Series of 2013.