REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________ ) S.S.
AFFIDAVIT OF DISCREPANCY
For Date of Birth
I, _________________________________, Filipino, of legal age, married, and presently
residing at
______________________________________________________________________________
_____________, after having been sworn in accordance with law, do hereby depose and state:
1. That I acquired a copy of my Birth Certificate from the Philippine Statistics
Authority, which states that I was born on __________________;
2. That I also obtained a copy of my Certificate of Baptism, issued by
_______________________________, which states that I was born on
___________;
3. That during my childhood years, my parents represented to me, as well as in my
school and other official records, that I was born on ___________________;
4. That from my childhood until my adult years, I was accustomed to indicating in all
my official records that my year of birth was _________, rather than ________; and
5. That I am executing this Affidavit to attest to the truth of the foregoing facts and to
address any discrepancies that may arise from my official documents which bear the
date of my birth as “______________”.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of
________, 2025 at ________________________, Philippines.
_______________________________
Affiant
SUBSCRIBED AND SWORN to before me this ___ day of _______________, 2025 at
__________________, Philippines, Affiant exhibiting to me his/her ______________________
issued on _______________ and valid until _______________ .
NOTARY PUBLIC
Doc. No. :____;
Page No. :____;
Book No. :____;
Series of _____.