REPUBLIC OF THE PHILIPPINES )

xxxxxxxxxxxxxxxxxxx ) S. S.
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx )

AFFIDAVIT OF DISCREPANCY
(ONE AND THE SAME PERSON)

I, xxxxxxxxxx, Filipino, of legal age, single, and with address at brgy.

xxxxxxxxxxxxxxxxxxxxxxafter having been duly sworn to in accordance with law
hereby depose and say:

1.) The Civil Registry Form No. 1A issued on March 23, 1998 at Malolos, Bulacan
and is attached to this affidavit indicates my name as xxxxxxxxxxxxxxxxxxxxxx;

2.) On the other hand, in the Certificate of Live Birth issued sometime in January of
2020 at Dumaguete City and is also attached to this affidavit, my name is
indicated as xxxxxxxxxxxxxxxxxxxxxxxxxx;

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 purposes
it may serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereby affix my signature this May 19, 2020 at

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.

xxxxxxxxxxxxxxxxxxxxxx
AFFIANT

TYPE OF I.D. : PHIL. HEALTH

xxxxxxxxxxxxxxxxxxxxxxxxxxxx

SUBSCRIBED AND SWORN TO before me this May 19, 2020 in

xxxxxxxxxxxxxxxxxxxxxxxxxxxx, affiant xxxxxxxxxxxxxxxxxxxxxxxxxxxxx personally
appeared before me and exhibiting to me his competent evidence of identity above
written.

Doc. No._____;
Page No._____;
Book No._____;
Series of 2020.