Republic of the Philippines )

Province of Cagayan ) S. S.
City of Tuguegarao )
x--------------------------------------x

AFFIDAVIT OF DISCREPANCY
(As one and the Same Person)

I, EDNA D. ABUYUAN, Filipino, of legal age, married and a resident of Ugac Norte
Tuguegarao City Cagayan, after being duly sworn to in accordance with law, hereby
depose and state:

1. That my deceased mother PATRICIA BANGAYAN-DAYAG was admitted at St.

Paul Hospital-Tuguegarao City on November 10, 2018;

2. That during admission, it was inadvertently written in her record that her name was
PATRICIA PAGULAYAN-DAYAG;

3. That however, the truth of the matter is that her real full name is PATRICIA
BANGAYAN-DAYAG and not PATRICIA PAGULAYAN-DAYAG;

4. That the name therefore as indicated in her record as PATRICIA BANGAYAN-

DAYAG and the name PATRICIA PAGULAYAN-DAYAG are one and the same;
and

5. That this instrument is hereby executed in order to attest the truth of the foregoing
and for whatever legal purpose it may serve most especially on her Death
Certificate.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 16th day of

November 2018 in Tuguegarao City, Cagayan, Philippines.

EDNA D. ABUYUAN
Affiant

SUBSCRIBED AND SWORN to before me this 16th day of November 2018 in Tuguegarao
City, Cagayan, Philippines. Affiant exhibiting to me a government issued Identification
card as proof of identity.

Notary Public

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