REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SIQUIJOR ) S.S.

AFFIDAVIT OF DISCREPANCY

I, ____________________________, of legal age, single, Filipino, and currently residing

at Timbaon, San Juan, Siquijor, after being duly sworn to in accordance in law, hereby dispose
and say, that:

1. My Birthday is January 20, 1995 as stated and registered in my birth certificate issued at
the Local Civil Registrar of the Municipality of San Juan, Siquijor. A copy of my birth
certificate is hereto attached as ANNEX A;
2. In the Certificate of Eligibility for Civil Service Professional issued by the Civil Service
Commission, my birthdate was mistakenly written as January 20, 1994;
3. My true birthday is January 20, 1995 and not January 20, 1994;
4. I am executing this Affidavit to attest to the truth of the above statement and for
whatever purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature on this day of

__________________________ at Siquijor, Siquijor, Philippines.

____________________________________

AFFIANT

SUBSCRIBED AND SWORN to before me on this day of

____________________________ in Siquijor, Siquijor, Philippines. Affiant exhibited as
evidence of identity his Non-Professional Driver’s License No. which expires on 2021/01/20.

NOTARY PUBLIC

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