REPUBLIC OF THE PHILIPPINES)

CITY OF CAGAYAN DE ORO )S.S.

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

AFFIDAVIT OF DISCREPANCY

I, JUANA TORRES DE LA CRUZ, of legal age, single, Filipino, a

resident of ILIGAN CITY, and mother of JOANNA TORRES DE LA CRUZ,
of minor age, after having been duly sworn to in accordance with law,
depose and state THAT:

1. My daughter’s Certificate of Live Birth indicates her middle name as

“TORRES”;

2. During her application for the renewal of her passport, I submitted my

Passport for the fulfillment of the required Mother’s Identification.
However, I discovered that there is a DISCREPANCY between the middle
name indicated in my Passport, which is “TORREZ”, from that of my
daughter’s Certificate of Live Birth, which is “TORRES”. Therefore, me
and my daughter’s true and correct middle name is “TORRES”, which is
in accordance with her Certificate of Live Birth;

3. All these documents pertain to one and the same person;

4. I am executing this affidavit to attest to the veracity of the foregoing

and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 11th

day of September 2023 in Cagayan de Oro City, Philippines.

JUANA TORRES DE LA CRUZAffiant

PhilHealth ID No: 11-1111111-1

SUBCRIBED AND SWORN TO before me this 11th day of September

in Cagayan de Oro City, Philippines, affiant exhibiting to me her
competent proof of identity indicated below her name.

WITNESS MY HAND AND SEAL.

Doc. No. ___;

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