REPUBLIC OF THE PHILIPPINES)

CITY OF MARIKINA ) S.S.

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

AFFIDAVIT OF DISCREPANCY
(Correction of Middle Name)

I, VILLANUEVA, JOSE JR REPISO, of legal age, Filipino, and a resident of b7 Lot 33 La

Poblacion Phase 3 Muzon City of San Jose Del Monte Bulacan, after having been duly sworn
to in accordance with law, depose and state THAT:

1. I was born on the 5th of August 1982 as reflected in my birth certificate and registered with the
Philippine Statistics Office (PSA);

2. I have been using the said name as evidence in my National Police Clearance issued on June
11, 2024 and valid until December 11, 2024;

3. However, I apply for a driver’s license with ID No. N25-06-003599, my name indicated therein
is VILLANUEVA, JOSE JR REPIZO. My middle name was erroneously type as “REPIZO”
and not “REPISO”.

4. That the name VILLANUEVA, JOSE JR REPISO and VILLANUEVA, JOSE JR.
REPIZO refer to one and the same person.

5. I execute this Affidavit of Discrepancy of my name to attest to the truth of the foregoing facts
and to explain the discrepancy between the driver’s license and NBI Clearance.

6. That I also execute this affidavit to correct my name in my driver’s license.

IN WITNESS WHEREOF, I have hereunto set my hand

this ___________________ in Marikina City, Metro Manila, Philippines.

VILLANUEVA, JOSE JR. REPISO

Affiant

SUBCRIBED AND SWORN TO before me this ___________________ in

_________________, Philippines, affiant exhibiting to me his/her competent evidence of
identity by way of NBI Clearance issued at Quezon City on June 11, 2024.

Doc. No. _____;

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