REPUBLIC OF THE PHILIPPINES)

QUEZON CITY, METRO MANILA) S.S.

AFFIDAVIT OF EXPLANATION

I, VALILIEAN INES BERGONIA, Filipino, of legal age, married, and resident of Blk 1
Lot 40 Villa Rebecca Homes 3, Banlat Road, Tandang Sora, Quezon City, after
having been sworn in accordance with law hereby depose and state.

1. That I was born on February 24, 1993 in Al Qatif Central Hospital, Riyadh,
Kingdom of Saudi Arabia;

2. That when my parents came back to the Philippines on year 1993 and secured
my birth certificate, the Philippines Statistics Authority told them that my birth
certificate record was non-existent;

3. That then they filed for my late registration of birth on July 31, 1993 in San
Quintin, Pangasinan with Local Civil Registry No. 93-460;

4. That when they came back to PSA to secure my birth certificate, a copy of my
birth certificate from Saudi Arabia was issued to them realizing that Al Qatif
Central Hospital just forgot to file immediately my birth certificate at the Philippine
Embassy in Saudi Arabia;

5. That I fully attest that my correct birth certificate was the one issued by the Al
Qatif Central Hospital, Riyadh, Kingdom of Saudi Arabia;

6. That I am executing this affidavit to attest to the truthfulness and honesty of the
foregoing facts and for all intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this _________________ at

Quezon City, Metro Manila.

VALILIEAN INES BERGONIA

Affiant
PRC ID No.: 0926177
SUBSCRIBED AND SWORN to before me this ______________ at Quezon City, Metro
Manila.

Doc. No. ______

Page No.______
Book No.______
Series of 2021