REPUBLIC OF THE PHILIPPINES )

MANILA ) S.S.

AFFIDAVIT OF DISCREPANCY

I, ROSA CAROLINA A. DE LEON, of legal age, Filipino, married and a

resident of # 2 Urbano Plata St., Caloocan City, after having been duly sworn to in
accordance with law, hereby depose and state;

That my true and legal name is ROSA CAROLINA A. DE LEON, recorded as

my name in my Live Birth Certificate and all legal documents;

That when I secured to get a copy of my PHILHEALTH RECORD found out that
my name appeared as CAROLINA A. DE LEON instead of ROSA CAROLINA A. DE
LEON the true and correct name that I have been using in my legal documents;

That CAROLINA A. DE LEON and ROSA CAROLINA A. DE LEON belong

to one and the same person;

That I am executing this affidavit in order to attest the truth of the foregoing facts
and for all legal intent it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this 10th day of April
2012 at Manila Philippines.

ROSA CAROLINA A. DE LEON

Affiant

SUBSCRIBED AND SWORN to before me this 10th day of April 2012 at

Manila, Philippines, affiant exhibited to me her CTC No. _______________ issued on
_________________ at _______________________.

Doc. No.: _____________ NOTARY PUBLIC

Page No.: _____________
Book No.: _____________
Series of 2012