Republic of the Philippines )

Province of La Union ) Sc.

City of San Fernando )

AFFIDAVIT OF DISCREPANCY

I, ERNESTO CACDAC BAUTISTA, 41 years old, married, Filipino

citizen, and a resident of Casilagan, Naguilian, La Union, after having been
duly sworn to an oath in accordance with law do hereby depose and state
that:

1. My child, CARL BRYAN VIRANA BAUTISTA’s fact of birth is to be

registered with the Local Civil Registrar, San Fernando City, La Union;

2. As one of the requirements for the registration of his birth, I was asked to
submit a copy of my Certificate of Live Birth with the Ilocos Training
Regional Medical Center (ITRMC);

3. However, my name was erroneously indicated in the said Certificate of

Live Birth as BABY BOY CACDAC BAUTISTA instead of my correct name
which is ERNESTO CACDAC BAUTISTA as appearing in my Voter’s ID
and PhilHealth ID;

4. Said mistake may have been caused by inadvertence only;

5. I vouch that my true and correct name is ERNESTO CACDAC BAUTISTA;

6. I further vouch that the person whose Certificate of Live Birth is BABY
BOY CACDAC BAUTISTA and the person whose name in his
identification cards is ERNESTO CACDAC BAUTISTA refer to one and the
same person and that is me;

7. I also vouch that I shall cause the correction of my Certificate of Live

Birth as soon as possible;

8. I am executing this affidavit to attest to the truth of the foregoing facts

and circumstances and for all legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6th day of

August 2019 in San Fernando City, La Union.

ERNESTO CACDAC BAUTISTA

Affiant

SUBSCRIBED AND SWORN to before me this 6th day of August

2019 in San Fernando City, La Union.