REPUBLIC OF THE PHILIPPINES)

CITY OF QUEZON, M. MLA. ) SS.

AFFIDAVIT OF BIRTH DATE DISCEPANCY

I, MA. BERNADETTE U. GENIL, of legal age, single, Filipino citizens, with residence and postal
address at Blk 13 Lot 16 Angelina Homes, Ampid I – San Mateo, Rizal, after having sworn to law depose
and say:

That I am a student of STI-School at Fairview, Quezon City and as such I was issued by the STI a
School I.D.;

That the said STI School I.D. issued to me was misplaced and despite earnest effort I exerted to
find/locate the same could not be found/located ;

That I executed this affidavit to establish the veracity of the loss of the said STI School I.D..

IN WITNESS WHEREOF, we hereunto our hands this ___ day of February, 2018 at Quezon City.

MA. BERNADETTE U. GENIL

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of February, 2018 at Quezon City.

Doc. No. ___

Page No.___
Book No. ___
Series of 2018