Republic of the Philippines )

City of Bacolod ) S.c.

x--------------------x

AFFIDAVIT OF ONE AND THE SAME PERSON

I, _____________________, Filipino, married, of legal age, with

address at _____________________City, after being sworn according to
law, hereby depose and state that:

1. I was known by the name “_____________________” and have used

the same in my birth certificate and passport, as shown by the copies
attached hereto as Annexes “A” and “B”.

2. My name was also recorded as “_____________________”, and I

have used the same on my driver’s license, as shown by the copy
attached hereto as Annex “C”.

3. I am executing this affidavit to attest to the foregoing statement to

prove that the names “_____________________” and
“_____________________” refer to one and the same person, the
Affiant.

_____________________
Affiant

SUBSCRIBED AND SWORN to before me this ________________, the affiant

exhibiting to me his _______________________ ID No _____________________ issued at
___________________ on _________.

Doc. No. _______

Page No._______
Book No._______
Series of 2022.