REPUBLIC OF THE PHILIPPINES)
PROVINCE OF [PROVINCE] )S.S.
CITY/MUN. OF [TOWN] )
x-------------------------x
AFFIDAVIT OF DISCREPANCY
I, [CLICK HERE AND TYPE NAME] , of legal age, married to
[Name of Spouse] , Filipino, and a resident of [Address] , after having
been duly sworn to in accordance with law, do hereby depose and
say:
1. That I was born on [Date of Birth] at [Place of Birth] from Sps.
[Name of Father] and [Name of mother] ;
2. That since my school days and up to the present, I have been
using the name “[NAME USED] ”; however, when I secured a
certified copy of my CERTIFICATE OF LIVE BIRTH from the
National Statistics Office (NSO), I learned that my registered
name is “[NAME REGISTERED] ”;
3. That I do hereby declare under oath that [NAME USED]
[MIDDLE NAME] [SURNAME] and [NAME REGISTERED]
[MIDDLE NAME] [SURNAME] refers to one and the same
person, that is, the undersigned;
4. That I am executing this affidavit to attest to the truth of the
foregoing facts for all legal intents and purposes.
IN TESTIMONY WHEREOF, I have hereunto set my hand this
21 day of April, 2020 at [Town, Province] .
[CLICK HERE AND TYPE NAME]
Affiant
ID Card No. [Number] ;
Issued on [Date] at [Place] ;
CTC No. [Number] ;
Issued on [Date] at [Place] ;
SUBSCRIBED AND SWORN to before me this 21 day of April,
2020 at [Town, Province] .
Doc. _________;
No.
Page _________;
No.
Book _________;
No.
Series 2020.
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