AFFIDAVIT OF DISCREPANCY

I, , 81 years old, Filipino, married and residents, under oath hereby

depose and state:

1. That the DSWD is giving financial assistance to the selected indigent Senior
Citizens of and I am one of the beneficiaries;

2. That today, I was called at the Office of the DSWD for the release of my
check/financial assistance but in the Landbank check and the voucher on file
with the DSWD my name appearing therein is;

3. That I am the same issued in by the DSWD in my favor;

4. That I am now executing this affidavit to attest to the fact that, refers to one
and the same person, the undersigned affiant, lawful beneficiary of the
financial assistance given by the DSWD;

5. That I further execute this affidavit to attest to the veracity of the above-
stated facts and for whatever legal purpose this may serve;

IN WITNESS WHEREOF, we have hereunto affixed our signature this 8 th day

of September, 2015 in the.

SUBSCRIBED AND SWORN to before me this 8 th day of September, 2015 in

the