Republic of the Philippines )

Lagawe, Ifugao )) S.S.

AFFIDAVIT OF EXPLANATION with REQUEST FOR CORRECTION

I, PEDRO O. NIBATEN, JR., of legal age, married, Filipino Citizen and with residence
located at Poblacion, Kiangan, Ifugao, after having been duly sworn to in accordance
with law, do hereby state that:
1. The facts of my birth were duly registered with the Local Civil Registrar of
Kiangan, Ifugao and as a consequence thereof, I was issued a Certificate of Live
Birth;

2. In the said Certificate of Live Birth, the entry for Date of Birth was entered as
September 15, 1962. However, when I was already of school age, I was told by
my parents that my date of birth is September 15, 1963. Henceforth, I had been
using the year 1963 as my year of birth in all my transactions such as in my school
records, government records, baptismal certificate and other transactions;

3. However, after inquiry, I found out that my actual year of birth is that stated in my
Certificate of Live Birth. Thus, I am now stating that the year of my birth is
September 15, 1962 and not September 15, 1963 and hereby request that the
entry for my year of birth be corrected to reflect my real year of birth;

4. Wherefore, I am executing this affidavit to attest to the truth of all the foregoing
facts and for all legal intents and purposes;

5. I have executed this affidavit freely and voluntarily and that I was not forced,
coerced nor intimidated in the execution of this document.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th day of

September 2022 at Lagawe, Ifugao.

PEDRO O. NIBATEN, JR.

Affiant

SUBSCRIBED AND SWORN BEFORE ME, this 9 th day of September 2022 at

Lagawe, Ifugao by the affiant who are personally known to.