REPUBLIC OF THE PHILIPPINES)

PROVINCE OF MAGUINDANAO)
CITY OF COTABATO )

AFFIDAVIT OF DISCREPANCY

I, APNA MAMAKON ABPI, of legal age, Filipino, married and a

resident of SAMBULAWAN, DATU PIANG, MAGUINDANAO,
PHILIPPINES, after being duly sworn to in accordance with law hereby
depose and state:

1. That I am a bona fide member of Philhealth;

2. That I put my husband Muslimin Abpi Abubakar as my beneficiary

therein;

3. That I erroneously put his name and date of birth in Philhealth

records as MUSLIMEN ABPI ABUBAKAR and JULY 01, 1971
instead of her true and correct date which is MUSLIMIN
ABUBAKAR ALI and FEBRUARY 25, 1979, as now correctly
reflected in the hospital records;

4. That said error in Philheath records is due to mere inadvertence on

my part in filling up the documents;

5. That, I am executing this Affidavit of Discrepancy to attest to the

truth of all the foregoing facts and for any legal purpose it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this May 17,

2024 at Cotabato City, Philippines.

APNA MAMAKON ABPI

Affiant ID Type/No:

SUBSCRIBED AND SWORN TO before me this May 17, 2024 at

Cotabato City. The affiant personally appeared before me presenting her
identification card as indicated above.

WITNESS MY HAND AND SEAL.

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