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Republic of the Philippines )

Tarlac City ) s.s.

AFFIDAVIT OF DENIAL

I, ROSEMARIE CORTEZ GARCIA, of legal age, Filipino, single and


a resident of Mayang, La Paz, Tarlac, after having been sworn to in
accordance with law, hereby deposes and states - that:

1. I am applying for a Tax Identification Number (TIN) with the Bureau of


Internal Revenue (BIR)- Tarlac City Revenue District Office;

2. However, the said BIR Office has informed that they could not process
my TIN application because a name of a person (who had already been
issued a TIN) similar to mine appeared in the BIR database/files;

3. The name “ROSEMARIE CORTEZ GARCIA” as appearing in the BIR


records with an existing TIN is not me because my personal
circumstances including my birthday, address, name of parents, etc are
not the same as that person carrying such similar name;

4. I am executing this affidavit to attest to the foregoing facts and to deny


categorically and specifically under oath that I am not the same person
appearing in the BIR records with an already issued/designated TIN;

5. In view of the foregoing, I am requesting the BIR Tarlac City Office to


issue the corresponding TIN;

IN WITNESS WHEREOF, I hereby affixed my signature this ____


day of ____________ in the City of Tarlac, Philippines.

ROSEMARIE CORTEZ GARCIA


Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this _____ day at


Tarlac City, Philippines.

Doc. No._______;
Page No._______;
Book No._______;
Series of 2018.