REPUBLIC OF THE PHILIPPINES)

DONE IN THE CITY OF BAGUIO) S.S.

AFFIDAVIT OF DISCREPANCY

I, KIMBERLY CABUTOT EJERCITO, Filipino, of legal age, single, and with resident at No.
893 Yanggacan, Tuding, Itogon, Benguet, Philippines, after having been duly sworn to in accordance
with law, hereby declare and state that:

1. I was born on May 29, 1991 in Baguio Medical Center, Inc. Baguio City, Philippines from
the Spouses Edward Noble Ejercito and Priscilla Baniwas Cabutot Ejercito . A copy of my
birth certificate is herein attached as Annex “A” and made an integral part of this affidavit;
2. I have eight (8) siblings, one of whom is Jacqueline Ejercito who was born on September
15, 1980. A copy of her birth certificate is herein attached as Annex “B” and made an
integral part of this affidavit;
3. In my birth certificate, my middle name was correctly indicated as “Cabutot” as our mother
was formerly Miss Priscilla Baniwas Cabutot;
4. In my sister’s birth certificate, however, her middle name was registered or indicated as
“Wallace”. The name “Wallace” is the first name of my mother’s father Wallace Cabutot;
5. The use of “Wallace” as the middle name of my sister in her birth certificate was in
accordance with our customs and traditions wherein the first name of elders is used by the
children as family name;
6. That the names Priscilla Baniwas Cabutot and Priscilla Wallace refer to one and the same
person who is our biological mother;
7. That the above-stated discrepancy is due to the reasons above-stated and not for any illicit
purposes;
8. That I am executing this affidavit to attest to the truthfulness of the foregoing facts and for
ALL LEGAL INTENTS AND PURPOSES this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 21th day of January 2019 in the
City of Baguio, Philippines.

KIMBERLY CABUTOT EJERCITO

Affiant
VIN 1106-0073B-E2991KCE20000

SUBSCRIBED AND SWORN to before me this this 21th day of January 2019 in the City of
Baguio, Philippines, affiant exhibiting to me her valid identification card indicated below her name as
competent proof of her identity.

Doc. No. ____;

Page No ____;
Book No. ____;
Series of 2019.