AFFIDAVIT

OF ONE AND SAME PERSON

WE, _________________________, Filipino, all of legal age, with address at

Barangay ________________________________, Davao del Norte, having been duly sworn
in accordance with law, hereby depose and say:

1. That, the TCT No. _____, under the name of________________, et. al., located at
Barangay _________________________, indicates the name
____________________________, as annotated in the title (a copy of which is
hereto attached as Annex “A”);

2. On the other hand, in the Birth Certificate issued by Philippine Statistic

Authority (PSA), indicates my name as ______________________ (a copy of
which is hereto attached as Annex “B”);

3. That, both names/documents pertain to one and same person;

4. As such, We executed this affidavit to certify or attest to the truth of the

foregoing facts and for whatever legal purpose this Affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my signature this ____________, 2024 at

__________________________, Davao del Norte, Philippines.

___________________________ ___________________________
Affiant Affiant
I.D. No. __________________ I.D. No. __________________

SUBSCRIBED AND SWORN to before me at ______________________, Davao del Norte,

Philippines this ________________________, 2024 personally appeared affiant with her/his
respective Identification Cards printed below their name.

Doc. No. __________;

Page No. __________;
Book No. __________;
Series of 2024