REPUBLICOF THE PHILIPPINES

PROVINCE OF BOHOL
CITY OF TAGBILARAN
AFFIDAVIT OF DISCREPANCY
I, CIRILO SAMPILO CALATRAVA, Filipino, of legal age, married with an
office address at Dep.Ed Division of Bohol, New Capitol Site, Tagbilaran City,
Bohol, after having sworn to before me in accordance with the law do hereby
depose and say:
1. That my name as registered in my Birth Certificate is CIRILO
SAMPILO CALATRAVA;
2. That my name as reflected and used in my school records, and other
public documents is CIRILO SAMPILO CALATRAVA;
3. That when I got married, my mothers name under the entry of the
grooms mother was reflected as ROMANA SAMPILA instead of
ROMANA SAMPILO in my marriage contract;
4. That said discrepancy in the family name of my mother in the record
of my marriage ROMANA SAMPILA, and my registered name
reflected in all of my school records and public documents ROMANA
SAMPILO is a discrepancy not attributable to the control of herein
affiant, and that the name ROMANA SAMPILA, AND ROMANA
SAMPILO, all refers to the same person and that is ROMANA
SAMPILO;
5. That I vouch to the veracity of the said circumstances and that I hereby
execute this affidavit to reconcile the discrepancy of the entry of my
MOTHERS name in my birth record and other public documents and
the entry of HER name in my marriage contract and for whatever legal
purpose it may serve.
IN WITNESS WHEREOF, I have here unto set my hand this _______________
at Tagbilaran City, Bohol, Philippines.

CIRILO SAMPILO CALATRAVA

Affiant
Dep. Ed I. D No._________________
Issued at Tagbilaran City, Bohol.
SUBSCRIBED AND SWORN TO before me on the date and place
abovementioned.
Doc.No._____;
Page No.____;
Book No. VI
Series of 2016