Republic of the Philippines )

City of __________________ ) S.S

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

AFFIDAVIT OF CORRECTION OF CLERICAL ERROR

I, ___________________, Filipino, of legal age, married, with address at ______________

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

1. I am seeking the correction of clerical/ material error in my Certificate of Live Birth under registry
number ____________________, a copy of which is hereto attached marked as Annex “A;”

2. I was born on _________ at ________________ by parents, _____________ and

_____________;

3. The clerical/material error(s) to be corrected are as follows:

Item Description From To

4. Based on my personal knowledge, the foregoing errors were accidental and merely typographical
errors committed by the civil registrar officer and my parents at the time of registration. I have
recently discovered the foregoing mistake(s) in the entry upon closer inspection of my Birth
Certificate and thus, I immediately took action to correct such errors by reporting the same to the
proper government agency and seeking legal advice to make the necessary corrections;

5. In support of my claim, I likewise attached marked hereto the following documents and other
competent proof of my identity:

a. Joint affidavit of two disinterested persons, attached marked as Annex “B”

b. Certificate of Baptism, attached marked as Annex “C”
c. School Records, attached marked as Annex “D” and
d. Driver’s License, attached marked as Annex “E.”

6. I hereby execute this Affidavit in good faith, to attest to the truth of the foregoing facts to
support the petition for correction of clerical errors in my Certificate of Live Birth, and for other
legal purposes it may serve.

AFFIANT FURTHER SAYETH NAUGHT IN THE MEANTIME.

IN WITNESS WHEREOF, I hereunto affix my signature this ___ day of August 2023 at
_____________.

Affiant

SUBSCRIBED AND SWORN TO before me this ________ day of _________ 2023. Affiant
exhibiting to me her/his competent proof of identity: ________No. __________ issued by
____________ on ________ and valid until _____________.

Doc No. ____;

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