Republic of the Philippines)

QUEZON CITY )S.S.

AFFIDAVIT OF NAME VARIATIONS

I, ANN KATHLEEN C. BARLIN, of legal age, single and resident of No. 1 Mount
Rainier St., Batasan Hills, Quezon City, Philippines, after being sworn according to
law hereby depose and state that:

1. My full name is ANN KATHLEEN CABAHUG BARLIN, a medical doctor. This

is my name appearing in my Diploma issued by the St. Luke’s College of Medicine.

2. I am also known as ANN KATHLEEN C. BARLIN. The letter C stands for my

middle name CABAHUG. This is my name appearing in my certification by the
Professional Regulation Commission (PRC).

3. I am also known as ANN KATHLEEN C. BARLIN, M.D. which stands for as

Doctor of Medicine, which is my medical degree. This is my name appearing in my
certifications issued by the St. Luke’s Medical Center Internship Training Program
and The Philippine Board of Otolaryngology- Head and Neck Surgery, Inc. Diploma.

4. I am also known as BARLIN, ANN KATHLEEN CABAHUG which appears in

my Transcript of Records and Clinical Internship Grades.

5. The names ANN KATHLEEN C. BARLIN, ANN KATHLEEN CABAHUG

BARLIN, ANN KATHLEEN C. BARLIN, M.D. and BARLIN, ANN KATHLEEN CABAHUG
is one and the same person.

I am executing this Affidavit of Name Variations to attest the truth of the

different presentations of my name which refers to one and the same ANN
KATHLEEN CABAHUG BARLIN which is my full name.

ANN KATHLEEN CABAHUG BARLIN

Affiant

SUBSCRIBED and SWORN before me this 22 nd of December 2015, at Quezon

City, Philippines, affiant exhibited to me his Passport Number EB3688588 issued at
DFA Manila issued on September 21, 2011 and expiring on September 20, 2016.

NOTARY PUBLIC

Doc. No.: ___;

Page No.: ___;
Book No.: ___;
Series of 2015.