Republic of the Philippines)

City of Santiago ) Sc.

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AFFIDAVIT OF DISCREPANCY

I, MARIA LUISA B. TOLENTINO, of legal age, Filipino, and a resident of PK-2

Cebu, San Isidro, Isabela, Philippines, having been duly sworn to in accordance with law, hereby
depose and state:
1. That I have been using the name MA LUISA and/or MA. LUISA, as appearing
in some documents and records or specifically in the records of Social Security
System (SSS), as erroneously spelled instead of my true and correct name of
"MARIA LUISA";
2. That my true name is spelled as " MARIA LUISA " as recorded in my
Certificate of Live Birth issued by the National Statistics Office (A copy of
my Certificate of Live Birth is attached hereto and made an integral part of
this affidavit);
3. That I am executing this Affidavit of Discrepancy to attest to the truth of the
foregoing facts and to explain the discrepancy in some documents and records
as regards my true name.
IN WITNESS WHEREOF, I have hereunto set my hand this ___________________, at
Santiago City, Philippines.

MARIA LUISA B. TOLENTINO

Affiant

SUBSCRIBED AND SWORN to before me, this _____________________, by the

Affiant who is personally known to me and who exhibited her SSS ID No. 33-3306241-1 issued at
Santiago City, Philippines.

Doc. No. ______;

Page No. ______;
Book No.______;
Series of 2010.