You are on page 1of 1

REPUBLIC OF THE PHILIPPINES)

DONE: IN THE CITY OF BAGUIO ) S.S.


X - - - - - - - - - - - - - - - - - - - - - - - -X

AFFIDAVIT OF DISCREPANCY

I, KRISTINE P. GOMEZ-UNCLE, of legal age, Filipino, residing at, Baguio City, after having
been duly sworn to in accordance with law, hereby depose and state:

1. That KRISTINE GOMEZ y PANIC was my appellation duly registered and enrolled for my
formal education and I used in all of my private and public transactions;

2. That when I secured my Certificate of Live Birth from the National Statistics Office, I
discovered that my name entered and registered was BABY GIRL P. GOMEZ, however, my true and
real name KRISTINE PANIC GOMEZ was correctly registered and entered with the Local Civil
Registrar of Baguio City;

3. That the names BABY GIRL P. GOMEZ appearing in the Certificate of Live Birth registered
with the National Statistics Office, and the name KRISTINE P. GOMEZ appearing in my Certificate of
Live Birth registered with the Local Civil Registrar of Baguio City, refer to me alone;

4. That the failure to supply my real and true name with the National Statistics Office was due
to inadvertence, done in good faith and was not intended to hide my real identity for I was never
charge or sued in any forum for misdemeanor, crime or felony;

7. That I am executing this Affidavit to attest to the truthfulness of the foregoing and to supply
and register/reconcile the discrepancy of my name appearing in my Certificate of Live Birth at the
National Statistics Office, and Certificate of Live Birth at the Local Civil Registrar of Baguio City and
for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of October, 1990, in the
City of Baguio, Philippines.

KRISTINE P. GOMEZ-UNCLE
Affiant

SUBSCRIBED AND SWORN to before me this 29 th day of October, 1990, in the City of Baguio,
Philippines.

You might also like