Republic of the Philippines )

Quezon City ) S.S.

AFFIDAVIT OF DISCREPANCY

I, _______________________________, Filipino, of legal age and with

residence at _________________________________________________, after having
been sworn to in accordance with law, do hereby depose and state that:

1) I am ____________________________ as reflected in my Birth Certificate

which is hereto attached as Annex “A”;

2) When I got married, my birth date was erroneously indicated as

_____________________ in my Marriage Contract;

3) However, my true and correct birth date is _________________________,

as reflected in my birth certificate;

4) The said error is harmless and innocuous typographical/clerical

error;

5) I am executing this affidavit to attest to the truth of the foregoing

narration of facts and for whatever legal purposes and intents this
may serve.

IN TESTIMONY WHEREOF, I have hereunto affixed my signature on

_____________________ in Quezon City indicated in the Jurat.

________________________
Affiant

SUBSCRIBED AND SWORN to before me in Quezon City this ______ day of

_________________________ by ____________________, who has satisfactorily
proven to me her identity through __________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020