AFFIDAVIT OF DISCREPANCY

(Annotation of Specific Municipality of Place of Birth)

I, Angelica May B. Zaldivar, Filipino citizen, of legal age, single, with Philippine address at B10 L11 Hyacinth St..
Brgy. Malusak Santa Rosa Laguna, and presently residing in Santa Rosa Laguna, after having been duly sworn in
accordance with law, hereby depose and say:

1. That my place of birth is Rizal Medical Center, as stated and registered in my Certificate of Live Birth with
Registry no.: 99-3234 reported at Pasig City on March 1, 1999;

2. That during my childhood and adult years, I have been accustomed to the use of Rizal Medical Center as
my place of birth;

3. That I have used the place of birth, Rizal Medical Center, in the following personal and official documents:
a) Unified Multipurpose ID, b) Company Master file c) School TOR/Documents;

4. That, in my existing record I do not have the annotation of specific Municipality such as Pasig City
wherein Rizal Medical Center is located.

5. That I am undertaking to cause the correction of my place of birth appearing in my PSA birth certificate to
reflect my true place of birth as Rizal Medical Center, Pasig City; and,

6. That I am executing this Affidavit to clear any discrepancy which may arise from personal and official
documents.

FURTHER AFFIANT SAYETH NONE.

Issued this date: 25th day of June 2019.

Angelica May B. Zaldivar

Signature of Affiant