Republic of the Philippines )

City of Davao . . . . . . . . . . .)s.s.

x--------------------------------x

AFFIDAVIT of CHANGE OF ADDRESS

I, ISMAIL RUHAIL MOHAMED, of legal age, an Indian national, single and presently
residing at House 22, Road 2, Doña Vicenta, Barangay 10-A, Davao City, after having
been sworn to in accordance with law, hereby depose and state that:

1. I am an applicant for Alien Card Registration specifically for correction of

address at the Bureau of Immigration Office, Davao City.

2. I am requesting the Bureau of Immigration Office to correct my complete

address form Room #B11 2/F DMEMS Dorm, Jacinto corner Juan Luna
Street, Davao City, Davao del Sur, 8000 to House 22, Road 2, Doña Vicenta,
Barangay 10-A, Davao City 8000, Davao del Sur, Philippines.

3. I have stayed in the present address since March 02, 2019 up to the present.

4. I am executing this affidavit to attest to the truth of the foregoing facts and to
inform the proper authorities concerned of the matter and for such other legal
purpose which it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this March 22, 2019 in the
City of Davao, Philippines

ISMAIL RUHAIL MOHAMED

Affiant

SUBSCRIBED AND SWORN to before me this March 22, 2019 in the City of Davao,
Philippines. Affiant exhibiting to me his Davao Medical School Foundation Student
ID bearing No. 2017MED0001090 as competent proof of identity.

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