You are on page 1of 1

Republic of the Philippines ) Province of Isabela ) S. S.

City of Ilagan ) x-------------------------------x

AFFIDAVIT

I, MICHEL ANGELO BUGUINA BAUA, of legal age, single, Filipino and a resident of liss !illage, Ilagan City, Isabela, after having been duly s"orn to in accordance "ith la" hereby depose and say# $hat I a% the sa%e person executing this affidavit& $hat I a% a student of the Isabela State 'niversity, Ilagan City Ca%pus and is ta(ing up achelor of Science in Industrial $echnology& $hat I "as surprised to learn that in the school records %y na%e "as erroneously entered as )IC*+,- +./,-0 '/'I.+ +'+ instead of )IC*,- +./,-0 '/'I.+ +'+ as evidenced in %y Certificate of -ive irth attached herein& $hat the na%e entered in %y Certificate of -ive irth "hich is MICHEL ANGELO BUGUINA BAUA and the na%e entered in the school records "hich is MICHEL ANGELO BUGUINA BAUA refers to one and the sa%e person& $hat I a% executing this affidavit to attest to the truthfulness of the foregoing declaration. IN WITNESS WHEREOF, I have hereunto set %y hand this 1 rd day of February, 2345 at Ilagan City, Isabela.

MICHEL ANGELO BUGUINA BAUA +ffiant

S' SCRI ,6 +.6 S70R. to before %e this 8888 day of February, 2345 at Ilagan City, Isabela.

6oc. .o. 88888888 Page .o. 88888888 oo( .o. 88888888 Series of 2345