REPUBLIC OF THE PHILIPPINES )

AFFIDAVIT OF ONE AND THE SAME PERSON

I, ________________, of legal age, Filipino, single, presently residing at

________________, after having been sworn to in accordance with law hereby
depose and state, THAT:

1. The Certificate of Live Birth issued by the Office of the City Registrar,
__________________ my name appears as ________________.

2. However, my name was erroneously entered as ___________________ in

the birth certificate of my daughter ________________________

3. I state that _______________ and the ________________ is the name of

one and the same person and that is myself.

4. I have executed this affidavit to attest to the truthfulness of the foregoing

facts, and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 27 th

day of January 2020, at ________________________.

_______________________________
Affiant

SUBSCRIBED and SWORN to before me this 27th day of January 2020 at

____________________ and I further certify that he has read the contents of his
affidavit and understands the same.

Doc No._________;
Page No.________;
Book No._______;
Series of 2020.