REPUBLIC OF THE PHILIPPINES )

Province of Negros Occidental ) S.S.

City of Bacolod)
X --------------------------------------- X

JOINT AFFIDAVIT OF DISCREPANCY

WE, _______________________, of legal age, Filipino and resident of _____________

and ___________________, of legal age, Filipino, and resident of
__________________, after being duly sworn to in accordance with law, hereby
depose and state:

1. That we personally know ________________________ because we are

_________________;

2. That the correct name of ___________________________ is

____________________________ as appearing in ______ Certificate of Live
Birth;

3. That _______________________________ and

_____________________________________, refer to one and the same
person;

4. That we are not related to the above-named person, either by

consanguinity or affinity, nor do we have pecuniary interest in this
matter whatsoever.

5. That we are executing this affidavit to attest to the truth of the

foregoing statements and to establish the correct name of
_______________________________________.

IN WITNESS WHEREOF, we have hereunto set our hands this

______________________ at Bacolod City, Philippines.

_______________________ _________________________
Affiant Affiant
_______________________ ___________________________

SUBSCRIBED AND SWORN to before me this _______________________, at

Bacolod City, Philippines, affiants exhibiting before me their valid proofs of
identity as indicated below their respective names.

Doc. No. _____

Page No. _____
Book No. _____
Series of 2018