Republic of the Philippines )

______________________________ )S.S.

AFFIDAVIT OF DISCREPANCY

I, _____________________, of legal age, Filipino, and with address at

_________________, __________________, after having been duly sworn to in accordance with
law, depose and state that:

1. On ___________________, I celebrated my marriage with ______________ before the

Office of the Municipal Mayor of ___________, _________________;

2. When I secured a copy of our Certificate of Marriage from the Philippine Statistics
Authority, and after scrutinizing the same, I discovered that the recorded entries for
_______________________________ therein were ______________ instead of
_____________ which was as recorded in my Certificate of Live Birth and our Marriage
Contract. Hence the discrepancies;

3. I am executing this affidavit to attest to the fact that the names

______________________, as recorded in our Certificate of Marriage, and
______________________, as recorded in my Certificate of Live Birth and our Marriage
Contract, refers only to one and the same person, and that person is me;

4. Finally, I am executing this Affidavit to attest to the truth of the foregoing statements and
for whatever legal intents and purposes it may duly serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of December,
________ at the City of _____________, _____________, Philippines.

__________________________
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of ____________, ______at

the City of ____________, ________. Affiant exhibited to me his __________ ID with no.
_____________, as competent proof of his identity.

Doc. No.__________
Page No._________
Book No._________
Series of 202_