Republic of the Philippines )

Province of Kalinga )S.s

City of Tabuk )

AFFIDAVIT OF DISCREPANCY IN NAME

I, ROSALINA BALCANAO CABANNAG, of legal age, married,

and with address at Asibanglan, Pinukpuk, Kalinga, under
oath, state that:
1. That my name is ROSALINA BALCANAO CABANNAG as I
used in all of my public record and one proof of it is the
Katunayan ng Pagtatapos given by the BIBAK NATIONAL
AGRICULTURAL SCHOOL on March 30, 1979 that bears
my name ROSALINA CABANNAG. A copy of the
Katunayan sa Pagtatapos is hereto attached as ANNEX
“A” and my Marriage Contract, a copy of which is hereto
attached as ANNEX “B”;

2. That the middle name “KAWIL” in my Marriage Contract

was mistakenly entered in which my true and correct
middle name is “BALCANAO” which is my mother’s
maiden Family Name;

3. That I was born on November 12, 1959 and since then,

my friends and acquaintance call me ROSALINA
BALCANAO CABANNAG and thus since then I have been
accustomed to using the name ROSALINA BALCANAO
CABANNAG in my personal records, transaction and
communication;

4. That the name ROSALINA KAWIL CABANNAG and

ROSALINA BALCANAO CABANNAG refer to one and the
same person, the herein affiant;

5. That I am executing this affidavit to attest to the truth of

the foregoing facts and to use the same for whatever legal
purpose it may serve.

IN WITNESS WHEREOF, I hereto affix my signature this 2 nd

day of September 2020 at Bulanao, Tabuk City, Kalinga.
 ROSALINA BALCANAO CABANNAG
Affiant
ID No.___________________

SUBCRIBED AND SWORN to before me this 2nd day of

September 2020 at Tabuk City, Kalinga.

Doc. No. _______

Page No. _______
Book No. _______
Series of 2020