AFFIDAVIT OF DICREPANCY

( RE: ONE AND THE SAME PERSON)

I, MARISSA TUVERA INAY, Filipino, of legal age, married to DOMINADOR Y. INAY and a
resident of Nagsabaran Norte, Balaoan La Union after having been duly sworn to in accordance with law
depose and say:

1. The Local Civil Registrar issued on_______ at_______ indicates the name/birthday /place of
my birth-------as----------
2. On the other hand, in the ----------issued on------------ at------- the name birthday—place of
birth of my is indicated as------------
3. Both names/documents pertain to one and the same person
4. I am executing this affidavit to attest to the truth and for whatever legal services it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day of August 2020 at San
Fernando City Philippines.

MARISSA TUVERA INAY

Affiant

Republic of the Philippines)

Province of La Union)S.S.
City of San Fernando)
x---------------------------------------------------x

SUBCRIBED AND SWORN TO before me this 5th day of August 2020 at San
Fernando City La Union, Philippines. Affiant exhibiting to me her postal Id # PRN
889200164653 issued by the Philippine Postal Corporation. I hereby certify that I have examined
the affiant personally and that she voluntarily executed his affidavit and understood the same.

Doc. No.
Page no
Book No.
Series of 2020