REPUBLIC OF THE PHILIPPINES )

ZAMBOANGA CITY ) S.S.

AFFIDAVIT OF ONE AND THE SAME PERSON

I, MARIAM JARUNI KARBI, Filipino, of legal age, widowed, with residence at Ipil, Bongao,
Tawi-tawi, Philippines, after being duly sworn to in accordance with law, hereby depose and state:

1. That I was born MARIAM WARAS JARUNI on 18 May 1963 in Ipil, Bongao, Tawi-tawi (please
see attached Certificate of Live Birth);

2. That I later on got married to Mabbul Karbi and from then on and afterwards, I have been
using the name MARIAM JARUNI KARBI in my documents, two of which among many others
is my COMELEC Voter’s Certification where my name as recorded therein is MARIAM
JARUNI KARBI (please see attached Voter’s Certificate) and my Philippine Identification Card
where my name is recorded therein as MARIAM KARBI;

3. That I have been using the name MARIAM JARUNI KARBI and/or MARIAM KARBI in all my
documentations and official representations since the date of my marriage to Mabbul Karbi,
up to the present;

4. That, however, in my Pantawid Pamilyang Pilipino Program (4Ps) ID, my name was
erroneously listed/recorded as MARIAM JARUMI KARBI, with a likewise erroneous Date of
Birth recorded as 10/1/1974 (please see attached 4Ps Certification/ID);

5. That such name of MARIAM JARUMI KARBI and such erroneous date of birth of 10/1/1974
should be corrected by virtue of this Affidavit and my Certificate of Live Birth, as attached and
above-mentioned;

6. That I unequivocally attest and declare that the name MARIAM JARUMI KARBI in my 4Ps
Certification and ID is, nevertheless, one and the same person as MARIAM JARUNI KARBI;

7. That this Affidavit of One and the Same Person is executed for all legal intents and purposes it
may serve.

IN WITNESS WHEREOF, I have signed this affidavit on this 1st day of October 2022 at Zamboanga
City.

MARIAM JARUNI KARBI

Affiant

SUBSCRIBED AND SWORN to before me this 1ST day of October 2022, affiant who is personally
known to me, and/or has satisfactorily proven to me her identity through competent evidence, exhibiting
her government ID no. _______________ issued at ____________________ on _____________.

ATTY. TISHREEN I. BAHJIN

Doc. No. ; NOTARY PUBLIC - ZAMBOANGA CITY
Page No. ; COMMISSION UNTIL 31 DECEMBER 2022
Book No._II_; ROLL OF ATTORNEYS NO. 63070
PTR NO. 2403162 / ZAMBOANGA CITY / 04-13-2022
Series of 2022. IBP NO. 197492 / QUEZON CITY / 01-07-2022
MCLE COMPLIANCE NO. VII-0019689 / 05-31-2022