REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BATANGAS ) S.S.

CITY OF TANAUAN )

AFFIDAVIT OF DISCREPANCY

I, MARIA JASMINA MONDRAGON MONCAYO, Filipino, of legal age,

married, and a resident of Barangay Cale, Tanauan City, Batangas, after having
been duly sworn in accordance with law, do hereby depose and say THAT:

1. My name appearing in my Certificate of Live Birth is “MARIA

JASMINA M. MONCAYO”;

2. However, since childhood people were accustomed in addressing

me with the name “JASMINE MONCAYO”, which is my nickname;

3. As a result, when I was confined at the Batangas Medical Center

because of abdominal pain, my husband, Moises Moncayo, provided my nickname
JASMINE instead of my full name MARIA JASMINA to the medical attendant;

4. I also failed to inform the Batangas Medical Center of the said

discrepancy as I was accustomed in being addressed by both names;

5. “MARIA JASMINA M. MONCAYO” and “JASMINE M.

MONCAYO” is one and the same person;

6. I am executing this Affidavit to attest to the truthfulness of the

foregoing statements and to establish the fact that “MARIA JASMINA M.
MONCAYO” and “JASMINE M. MONCAYO” is one and the same person and
for whatever legal intents and purpose this may serve best.

Further Affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 28th

day of October 2016 at the City of Tanauan, Batangas.

MARIA JASMINA M. MONCAYO

Affiant

SUBSCRIBED AND SWORN to before me this 28th day of October 2016

at the City of Tanauan, Batangas, affiant exhibiting her Unified Multi-Purpose ID
with CRN 0111-3559840-2 bearing her picture and signature to prove her
identification.

MARIFEL B. DE LOS SANTOS

Public Attorney I
Pursuant to R.A. 9406