REPUBLIC OF THE PHILIPPINES )

DASMARINAS CITY, CAVITE ) S.S.

AFFIDAVIT OF DISCREPANCY

I, MA. LIEZL PEREZ JABON, of legal age, single, Filipino Citizen, and with residence
& postal address at Block 27 Lot 1B, Liwayway Homes Subd. Anabu 1-C, Imus City, Cavite,
respectively, and having been duly sworn to in accordance with law hereby depose and say;

That I am currently confined in Emilio Aguinaldo College- Medical Center;

That I know for a fact that in my Certificate of Live Birth, my first name appears as “MA.
LIEZL”, and I have been using the same in all my valid ID’s and documents; however, in
my EAC medical record, my first name appears as “MA. LIEZEL”;

That I hereby attest under oath that my true and correct name is “MA. LIEZL”;

That MA. LIEZL PEREZ JABON and MA. LIEZEL PEREZ JABON refer to one and
the same person;

That I am executing this affidavit to attest to the truth of the foregoing for all legal
intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this 19th day of December
2019, at Dasmarinas City, Cavite, Philippines.

MA. LIEZL PEREZ JABON

Affiant

SUBSCRIBED AND SWORN to before me on the day and place above-written, affiant
exhibiting to me his/her UMID NO. 0111-8900191-6

Doc. No. 389

Page No. 78
Book No. 09
Series of 2019