REPUBLIC OF THE PHILIPPINES )
_______________________________)
_______________________________) S.S.
AFFIDAVIT OF DISCREPANCY IN NAME
I, ______________________, of legal age, Filipino, married and a resident
of _______________________, after having been duly sworn to in accordance
with law hereby depose and state:
1. That my name is _________________ as stated and registered in my
Certificate of Live Birth issued by the Office of the Local Civil Registrar,
_____________. A copy of the certification issued by the Office of the Civil
Registrar________________ is attached herewith and marked as Annex
“A”;
2. That in the Certificate of Live Birth of my son, ______________, my name
was erroneously stated as ___________________;
3. That I have been using the name ________________ in all my personal
records, official transactions and communications;
4. That the name ________________ and ___________________ refer to one
and the same person, herein affiant;
5. That I am executing this Affidavit to attest to the truth of the foregoing facts
and to use the same for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I hereunto affix my signature this ____ day of
____________ at _________________.
_____________________
Affiant
SUBSCRIBED AND SWORN to before me this ______ day of
____________________ at ______________, Affiant exhibiting to me his
____________________.
_______________________