I, FELIPE SUMALBAG JUAN, 23 years old, Filipino citizen,
single, and a resident of Barangay Bobon Caarosipan, Camiling, Tarlac, Philippines, after having been duly sworn to in accordance with law, do hereby depose and state THAT:
1. I was born on March 13, 1994 to Spouses Dean Juan and
Divina Sumalbag at Babanuang San Manuel, Isabela;
2. Lately, I went to the Land Transportation Office, Tarlac City
(LTO Tarlac City) to apply for a Student Drivers License and was required to submit a copy of my Certificate of Live Birth;
3. When I secured a copy of my certificate of live birth from
the Philippine Statistics Authority (PSA), and after scrutinizing the same, I discovered that my recorded Name appearing therein is FELIPE SUMIBCAY JAUN, instead of FELIPE SUMALBAG JUAN, as appearing in my Police Clearance with Control No.:20170601019. Also, the name of my mother was recorded as DIVINA SUMIBCAY, instead of DIVINA SUMALBAG as recorded in her Certificate of Live Birth. Hence, the discrepancies;
4. I am executing this Affidavit to attest to the discrepancies in
the entries of my Name and in the Name of my mother in the said document;
5. Moreover, I am executing this Affidavit to attest to the fact
that the names FELIPE SUMIBCAY JAUN, as recorded in the above-said Certificate of Live Birth, and FELIPE SUMALBAG JUAN, as appearing in my Police Clearance with Control No.:20170601019, refer to one and the same person, and that is me;
6. Furthermore, I am executing this Affidavit to attest to the
fact that the names DIVINA SUMIBCAY, appearing as the mother of Felipe Sumibcay Jaun in the above-said Certificate of Live Birth, and DIVINA ALONZO SUMALBAG, as recorded in her Certificate of Live Birth, refer to one and the same person, and that is my biological mother, Divina Sumalbag Juan;
7. Finally, I am executing this Affidavit to attest to the truth of
the foregoing statements and for all legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my
signature this 1st day of June, 2017 at Camiling, Tarlac, Philippines.
FELIPE S. JUAN Affiant
SUBSCRIBED AND SWORN to before me on the date and
place indicated above. Affiant exhibited to me his Police Clearance with Control No.:20170601019 issued by the Camiling Police Station, Camiling, Tarlac on June 1, 2017.