Republic of the Philippines)

Province of Tarlac ) S.S.

City/Municipality of Tarlac)
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AFFIDAVIT OF DISCREPANCY

I, ROMELA SALVADOR UBALDO, of legal age, Filipino and a resident of Poblacion West, Sta.
Ignacia, Tarlac, after having been duly sworn in accordance with law, hereby depose and state –
THAT:

1. I was born on 6 May 1958 in Sta. Ignacia, Tarlac to spouses Teofila Colimay and
Estanislao Salvador;

2. In my Certificate of Marriage, my first name was erroneously entered as “ROMILA” instead

of “ROMELA”, while on my National Identification Card, may date of birth was erroneously
entered as “May 08, 1958” instead of “May 06, 1958”, as appearing on my Certificate of
Live Birth;

3. My true and correct name is “ROMELA” and not “ROMILA”, while my true and correct
birthdate is “May 06, 1958” and not “May 06, 1958”;

4. I am executing this affidavit to attest to the truth of the foregoing statement and facts.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of August 2023, at Tarlac
City, Philippines.

ROMELA SALVADOR UBALDO

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of August 2023, at Tarlac City,
Philippines.

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2023.