REPUBLIC OF THE PHILIPPINES )

PROVINCE OF LAGUNA ) S.S.

MUNICIPALITY OF PAGSANJAN )

AFFIDAVIT OF DISCREPANCY

I, ARNULFO BREGUERA ANCHETA, married, of legal age, Filipino

citizen, with residence and postal address at Brgy. Dingin, Pagsanjan
Laguna after having been duly sworn in accordance with law, hereby
depose and state:

1. That I am the husband of Jane Cabela Samonte hereto attached a copy

of our Marriage Contract;

2. That ever since I was a child I’ve been using the name “ARNULFO
BREGUERA ANCHETA” to all of my friends, family, acquaintances and
as well as to all my documents including my Certificate of Birth issued
by the Civil Registry of the Municipality of Pagsanjan Laguna.

3. That when I secured a copy of my Marriage Contract it came to my

notice that my first name and middle name appearing therein was
erroneously recorded as “ARNOLFO BREQUERA ANCHETA” instead
of “ARNULFO BREGUERA ANCHETA” the latter being my TRUE and
CORRECT name;

4. That for all legal intents and purposes and to remove confusion, I
hereby attest to the fact that the names “ARNOLFO BREQUERA
ANCHETA” and “ARNULFO BREGUERA ANCHETA”, being the latter’s
TRUE and CORRECT name. PERTAINS TO ONE AND THE SAME
PERSON;

5. That I am executing this Affidavit of Discrepancy to attest to the truth

of the foregoing statements and for whatever legal purposes it may
serve.

IN TESTIMONY WHEREOF, I have affixed my signature this___ day

of _________- in Sta. Cruz, Laguna.

ARNULFO BREGUERA ANCHETA

Affiant
Senior Citizens ID No. 10112010188

SUBSCRIBED AND SWORN to before me this ___day of ____, ____ in

Sta Cruz, Laguna. Affiant exhibited to me his valid identification shown
below his name and signature.

Doc. No. ___;

Page No. ___;
Book No._____;
Series of 2020