REPUBLIC OF THE PHILIPPINES)
City of Lucena ) S. S.
AFFIDAVIT OF DISCREPANCY
I, ______________________, of legal age, Filipino, married/single, and a
resident of _____________________, Lucena City, after having been sworn to in
accordance with law, do hereby depose and state that:
1. I was born at __________________ on ________________ to
spouses ____________________ and __________________ and was named
________________________ as it appeared on my Certificate of Live Birth;
2. However, in my _____________________, my name was entered
as _________________ and not ___________________ which is the correct
one;
3. My true name is ____________________ and not
_________________ which was inadvertently written on my birth certificate
which I would have to correct it administratively before the Civil Registry of
_____________________;
4. I am well known in our community as ______________ and not
________________________;
5. _________________ and _____________________ are one and
the same person; and
5. I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purpose it may serve.
Affiant sayeth naught.
Lucena City, ______________________.
_____________________
Affiant
SUBSCRIBED and SWORN to before me this ____ day of ________
2014 at Lucena City, affiant _____________ appeared in person, was identified
by me through competent evidence of identity by exhibiting to me her/his ID NO.
_______________ bearing her/his photograph and signature issued by the
__________________; signed the said Affidavit of Discrepancy in my presence;
and subscribed and sworn it before me.
Notary Public
Doc. No.
Page No.
Book No.
Series of 2014
REPUBLIC OF THE PHILIPPINES)
City of Lucena ) S. S.
AFFIDAVIT OF DISCREPANCY
I, ___________________________, of legal age, Filipino,
married/_______________, and a resident of __________________________,
Lucena City, after having been sworn to in accordance with law, do hereby
depose and state that:
1. I was born at _______________, on __________________ to
spouses __________________ and ________________and was named
____________________ and the same name appeared in my Certificate of Live
Birth;
2. However, in _________________, ________________ appeared
thereon instead of ____________________________;
3. My true name is ___________________, and not
___________________;
4. ___________________ and ______________________ are one
and the same person; and
5. I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purpose it may serve.
Affiant sayeth naught.
Lucena City, _____________________.
_______________________
Affiant
SUBSCRIBED and SWORN to before me this __ day of _____________
2014 at Lucena City, affiant _______________ appeared in person, was
identified by me through competent evidence of identity by exhibiting to me
his/her ID No. ________________________, bearing his/her photograph and
signature issued by the _____________________, and signed the said Affidavit
of Discrepancy in my presence.
Notary Public
Doc. No.
Page No.
Book No.
Series of 201
REPUBLIC OF THE PHILIPPINES)
City of Lucena ) S. S.
AFFIDAVIT OF LOSS
I, _________________________, of legal age, Filipino, single/married,
and a resident of _________________________, after having been sworn to in
accordance with law, do hereby depose and state that:
1. I am the holder an Identification Card issued by
_________________________;
2. That the said ID was lost last _______________ while
________________ when I noticed that my ____________ slipped through my
hip pocket;
3. Earnest effort has been exerted by me to find the said _______
but to no avail; and
4. I am executing this affidavit to attest to the truth of the foregoing
and for whatever legal purpose it may serve.
Affiant sayeth naught.
Lucena City, ____________________.
_______________________
Affiant
SUBSCRIBED and SWORN to before me this __ day of _____________
2014 at Lucena City, affiant _______________ appeared in person, was
identified by me through competent evidence of identity by exhibiting to me
his/her ID No. ________________________, bearing his/her photograph and
signature issued by the _____________________, and signed the said Affidavit
of Discrepancy in my presence.
Notary Public
Doc. No.
Page No.
Book No.
Series of 201
REPUBLIC OF THE PHILIPPINES)
City of Lucena ) S. S.
AFFIDAVIT OF LOSS
I, _________________________, of legal age, Filipino, married/single,
and a resident of __________________, after having been sworn to in
accordance with law, do hereby depose and state that:
1. I am the holder of an ________________________ issued by
_________________________;
2. The said ___________________ was lost last
_________________ as it was misplaced in our house at the above given
address;
3. Earnest effort has been exerted by me to find the said
_____________ but to no avail; and
4. I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purpose it may serve.
Affiant sayeth naught.
Lucena City, ________________ 2014.
__________________________
Affiant
SUBSCRIBED and SWORN to before me this __ day of _____________
2014 at Lucena City, affiant _______________ appeared in person, was
identified by me through competent evidence of identity by exhibiting to me
his/her ID No. ________________________, bearing his/her photograph and
signature issued by the _____________________, and signed the said Affidavit
of Discrepancy in my presence.
Notary Public
Doc. No.
Page No.
Book No.
Series of 201
REPUBLIC OF THE PHILIPPINES)
LUCENA CITY ) S. S.
JOINT AFFIDAVIT
We, _____________________ and ______________________, both of
legal age, single/ married, respectively, Filipinos, and residents of
_________________________ and ________________________________,
respectively, after having been sworn to in accordance with law, do hereby
depose and state:
1. That we are the long time friends of ________________________
of __________________________, Lucena City;
2. We personally aware that his true name is ___________________
and not ___________________________;
3. However in his/her _______________________, his/her name was
mistakenly entered as __________________________ instead of
__________________________;
4. ____________________________ and _____________________
are one and the same person; and
5. We are executing this joint affidavit to attest to the truth of the
foregoing and for whatever legal purpose it may serve.
Lucena City, ________________ 2014
________________________ _________________________
Affiant Affiant
SUBSCRIBED and SWORN to before me this ____ day of ____________
2014 at Lucena City, affiants ________________ and _______________
appeared in person, was identified by me through competent evidence of identity
by exhibiting to me their ID Nos.___________________ and
_________________, bearing their photographs and signatures issued by the
___________________ and _________________, respectively, and signed the
said Joint Affidavit in my presence.
Notary Public
Doc. No.
Page No.
Book No.
Series of 201
REPUBLIC OF THE PHILIPPINES)
CITY OF LUCENA ) S. S.
AFFIDAVIT OF NON- FILING OF INCOME TAX
We, Spouses ___________________ and __________________,
Filipinos, of legal age, and residents of _____________________, Lucena City,
after having been duly sworn to in accordance with law, do hereby depose and
state:
1. That we are the parents of _________________________, who
was born on _______________ at ______________________;
2. That my husband ____________________ is a tricycle driver and
his income is just enough to support our children who are all of school age;
3. That my husband and I are not filers of the annual INCOME TAX
RETURNS because our income is not in the bracket of taxable income; and
4. That we are executing this affidavit to attest to the truth of the
foregoing and for whatever legal purpose it may serve.
Lucena City,______________ 2014
____________________ _____________________
Affiant Affiant
SUBSCRIBED and SWORN to before me this ___ day ___________
2014 at Lucena City, affiants appeared in person, was identified by me through
competent evidence of identity by exhibiting to me their Identification
Nos.________________________ and ___________________________
photographs and signatures issued by the ____________________, and signed
the said Affidavit in my presence.
Notary Public
=
Doc. No.
Page No.
Book No.
Series of 2014
REPUBLIC OF THE PHILIPPINES)
CITY OF LUCENA ) S. S.
AFFIDAVIT OF NON-EMPLOYMENT
I, __________________________, of legal age, married/single, Filipino,
and a resident of ______________________, after having been sworn to in
accordance with law, do hereby depose and state that:
1. I was unemployed and did not work gainfully since
____________________ up to the present;
2. From the said date, I no longer have any job or work neither was I
gainfully employed by any firm or company;
3. I was therefore unemployed from _______________ to date and
therefore I have no income from the said date; and
4. I am executing this affidavit to attest to the truth of the foregoing
and for whatever legal purpose it may serve.
AFFIANT SAYETH NAUGHT.
Lucena City, _______________ 2014.
_________________
Affiant
SUBSCRIBED and SWORN to before me this __ day of _____________
2014 at Lucena City, affiant _______________ appeared in person, was
identified by me through competent evidence of identity by exhibiting to me
his/her ID No. ________________________, bearing his/her photograph and
signature issued by the _____________________, and signed the said Affidavit
of Discrepancy in my presence.
Notary Public
Doc. No.
Page No.
Book No.
Series of 201
