Republic of the Philippines )

Province of Isabela ) S.S.

Municipality of Roxas )
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AFFIDAVIT OF DISCREPANCY
I, RAMON GALUTAN QUIBILAN, Filipino citizen, of legal age and a
resident of Mabini, Gamu, Isabela, accordance with law, do hereby
depose and state:
1. That I am the same person executing this affidavit;
2. That I learned that there is discrepancy in my real name as written in my
SENIOR CITIZEN ID as compared to what was written in my certificate of
Live Birth and other legal documents while it was written with “Jr” as my
suffix as written in my Senior Citizen ID while it should be written
without “Jr” as written in my Certificate of Live Birth and other legal
documents.
3. That my true and real first name was RAMON GALUTAN QUIBILAN;
4. That I am RAMON GALUTAN QUIBILAN as my real name in all my legal
documents/transactions;
5. That I am executing this affidavit for the purpose to attest to the veracity
and truthfulness of the foregoing and for all legal intents and purposes.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hand this
________________at _____________________.

RAMON GALUTAN QUIBILAN

Affiant
SUBSCRIBED AND SWORN TO before me this _____________________
at_____________________.

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