AFFIDAVIT OF DISCREPANCY

I, _________________________________________________, of legal
age, single/married/widow, citizen of ______________________ and presently
residing at ______________________________________________________,
after having been duly sworn to in accordance with law, do hereby depose and
say:
That my name is __________________________________, as stated
and registered in my birth certificate issued by the local civil registrar in country
of my birth, Republic of the Philippines;
That during my childhood and adult years, I have been accustomed to
the use of the name ____________________________________;
That I assumed the name _____________________________, when I
signed official documents and exercised my professional work in Canada;
That the names ___________________ and_____________________
refer to one and the same person; and
That I am executing this Affidavit to clear any discrepancy which may
arise from official documents bearing either name ___________________ or
____________________ ;
IN WITNESS WHEREOF, I have hereunto set my hand this
_________________ at __________________________, Canada.

_______________________
(Affiant)

Signed in the presence of: ___________________ ____________________

at the Philippine Consulate General, Toronto, Ontario, Canada