Republic of the Philippines )

City of Baguio ) s.s.

AFFIDAVIT OF DISCREPANCY

I, DOMINIC PELAYO PIAO, Filipino, of legal age, single, and with residence at #42
Lopez Jaena, Aurora Hill, Baguio City after having been duly sworn to in accordance with law,
depose and say that:

1. I am DOMINIC PELAYO PIAO and was born on MAY 27, 1992 as evidenced by the
attached copy of my Certificate of Live Birth and Professional Driver’s License;

2. That on September 15, 2019 I was admitted at Baguio General Hospital and Medical
Center and I was accompanied by one of my brother;

3. That during my admission my brother erroneously written my name as MARK

ANTHONY P. DANGAYO and this was the name that was registered in my hospital
record;

4. That my true and legal name is DOMINIC PELAYO PIAO and not MARK
ANTHONY P. DANGAYO;

5. That the error or mistake was committed only because my nickname is MARK
ANTHONY DANGAYO and this is also the name that I have been using in my
social media account and is not made intentionally to cause damage nor to confuse
identities;

6. The names DOMINIC PELAYO PIAO and MARK ANTNONY P. DANGAYO

refers to ONE and THE SAME PERSON ONLY;

7. That I am executing this affidavit to correct the erroneous entries in my hospital

record;

8. Further I am executing this affidavit to prove the foregoing facts and to support my
request for the correction of the hospital record of my child;

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day of September
2019 at Baguio City, Philippines.

DOMINIC PELAYO PIAO

Affiant
PDL A05-14-005243

SUBSCRIBED AND SWORN to before me this 17th day of September, 2019 at Baguio
City, Philippines.

Notary Public
Doc. No.:_____;
Page No.:_____;
Book No.: ____;
Series of 2019
Republic of the Philippines )
In the City of Baguio )S.S

AFFIDAVIT OF TWO DISINTERESTED PERSON

We, PATRICK HENRY M. VILLANUEVA and EDWARD C. PUDLAO, of legal

ages, both married, Filipinos and resident of Baguio City respectively, after having been duly
sworn to in accordance with law hereby depose and state that:

1. We personally know PRISCILLA P. GALISTE who was born on November 16,

1955 at San Fernando, Pampanga to SPS. DESIDERIO PABLO and ROSITA
PALISOC;

2. We personally know the above-mentioned individual for reason that she has been and
still is our co-worker here at Baguio General Hospital and Medical Center;

3. Sometime on January 17, 2016 when she secures a copy of her Certificate of Birth at
Local Civil Registrar of San Fernando, she came to know that her name was supplied
simply as “PRISCILA”; that ever since, she had been using and is known by the name
“PRISCILLA”;

4. We are not in any way related to the above-named individual or in any way
interested as to the purpose of this affidavit;

5. We are executing this affidavit to attest to the veracity and truthfulness of the
foregoing declarations and for all legal intents and purposes this may serve.

IN WITNESS WHEREOF, We have hereunto affix our signatures this ___ day of
November 2016, at Baguio City, Philippines.

PATRICK HENRY M. VILLANUEVA EDWARD C. PUDLAO

Affiant Affiant
DL No. AO1-96-056373 DL No. AO1-87-018870
Valid until March 17, 2017 Valid until January 14, 2018

SUBSCRIBED AND SWORN to before me this ___ of November, 2016, at Baguio

City, Philippines.

Notary Public

Doc No.: _______;

Page No.: ______;
Book No.:______;
Series of 2016