Republic of the Philippines)

Province of Kalinga)
City of Tabuk) S.S.
AFFIDAVIT OF DISCREPANCY
             I,  NATY B. PULLIS, Filipino citizen, of legal age, married, and
currently residing at Bugnay, Tinglayan, Kalinga, after having been duly sworn
to in accordance with law, hereby depose and say:
 
1. That the facts and other circumstances of my birth were duly
registered with the Philippine Statistics Authority.

2. That when I secured a copy of my Certificate of Live Birth from the

Philippine Statistics Authority (PSA), I discovered that the middle
name of my father was inadvertently not indicated therein;

3. That the full and correct name of my father is BONG B. PULLIS as

indicated in his Certificate of Live Birth from the Philippine Statistics
Authority (PSA).

4. That since in all my documents and transactions, I used the full and
correct name of my father Bong B. Pullis with his middle name indicated
therein;

5. That I wish that my Certificate of Live Birth be corrected to reflect the

middle name of my father which is BAGSAO;

6. That I am now executing this this affidavit to attest the truth of the
foregoing narration and for all legal intents it may serve best.
  
             IN WITNESS WHEREOF, I have hereunto affixed my signature this 8th
day of July 2021 at Bulanao, Tabuk City Philippines.
        
 
NATTY B. PULLIS
VIN:3215-0016B-D1094NBP20000

            SUBSCRIBED AND SWORN to before me this 8th day of July 2021, by

the affiant who presented to me her identification card, the particulars of which
are indicated below her name and signature and that she is the same person
who signed the foregoing affidavit before me and acknowledged that she
executed the same.
 

Doc No.
Page No.
Book No.
Series of 2021..