REPUBLIC OF THE PHILIPPINES )

PROVINCE OF TARLAC ) S.S.

MUNICIPALITY OF PANIQUI )

AFFIDAVIT OF DISCREPANCY

I, ALITA TAGARA AUSTRIA, of legal age, Filipino citizen, married and with postal address
at Barangay Canan, Paniqui, Tarlac, after having been duly sworn to according to law hereby depose and
state:

1. That I was born on December 12, 1960 in Pance, Ramos, Tarlac to spouses Lazaro P.
Tagara and Flocerfida Victorio;

2. That in my Certificate of Live Birth, issued by the National Statistics Office (NSO), the
entry with respect to my first name was erroneously entered as ALETA, as it should be
ALITA, which is the true and correct spelling, as appearing in my LCR Form No. 1A
(Birth-Available) and in my other pertinent documents;

3. Further, my date of birth was erroneously entered as DECEMBER 18, 1960, as it should
be DECEMBER 12, 1960, as appearing in my LCR Form No. 1A (Birth-Available) and in
my other pertinent documents;

4. Furthermore, my mother’s first name was erroneously entered as FLOCERPIDA, as it

should be FLOCERFIDA, as appearing in my other pertinent documents;

5. That the errors as regards to my first name and date of birth and to my mother’s first name
in my Certificate of Live Birth was caused by plain and simple honest mistake in typing the
said entries, without any malicious intents or purposes and was not done in bad faith;

6. That the names, ALETA VICTORIO TAGARA with date of birth on DECEMBER 18,
1960, as appearing in my Certificate of Live Birth, ALITA VICTORIO TAGARA with
date of birth on DECEMBER 12, 1960, as appearing in my LCR Form No. 1A (Birth-
Available) and ALITA TAGARA AUSTRIA with date of birth on DECEMBER 12,
1960, as appearing in my other pertinent documents, refers to one and the same person;

7. That the names, FLOCERPIDA R. VICTORIO, as appearing in my Certificate of Live

Birth and FLOCERFIDA R. VICTORIO, refers to one and the same person;

8. That I am executing this affidavit in order to attest to the truth of the foregoing
circumstances, and for all legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 19 th day of February, 2018, at
Paniqui, Tarlac.

ALITA TAGARA AUSTRIA

Affiant

SUBSCRIBED and SWORN to before me, in the Municipality of Paniqui, Province of Tarlac, this
19th day of February, 2018, by Alita Tagara Austria, personally known to me and who in person signed
before me the foregoing affidavit. Affiant exhibited to me her SSS ID with No. 02-0385085-3, bearing
her name, picture and signature as proof of her identity.

Doc. No. _______;

Page No. _______;
Book No._______;
Series of 2018