Republic of the Philippines)
_________________________)S.S.
AFFIDAVIT OF DISCREPANCY
KNOW ALL MEN BY THESE PRESENTS:
I, ____________________________, of legal age, Filipino, single, and a
resident of _________________________, after having been sworn in
accordance with law, hereby deposes and states the following
that:
1. My name is ________________________ as stated and registered
in my birth certificate issued by the Office of the Local Civil
Register of _______. A copy of the said document is herein
attached as ANNEX “A”;
2. The name ________________ also appears in my daughter’s
Certificate of Live Birth. A copy of the said document is herein
attached as ANNEX “B”;
3. The name _____________________ and ______________________
refer to the one and the same person, the herein Affiant;
4. I execute this affidavit to attest to the truth of the foregoing
and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this
_____________, at __________________.
_________________________
Affiant
SUBSCRIBED AND SWORN to before me, this _____________,
at __________________, with affiant exhibiting her Voter’s ID.
Doc. No. : ___;
Page No. : ___;
Book No. : ___;
Series of 202_.
