REPUBLIC OF THE PHILIPPINES)

QUEZON CITY, METRO MANILA) S.S.

x---------------------------------------------------x

AFFIDAVIT OF DISCREPANCY

I, _______________________, of legal age, single, Filipino, and a resident of

_______________________, after having been duly sworn to in accordance with law
hereby depose and say that:

1. That in my Quezon City Citizen Card with No. _______________________, my

first name was incorrectly and erroneously written as
“_______________________”. 

2. That my correct first name is _______________________, as stated in my birth

certificate and other pertinent identification cards; 

3. That I am executing this Affidavit to attest to the truth of the foregoing

and in support of my application to correct said entry to reflect my first
name as _______________________. 

Affiant further sayeth naught.

IN WITNESS WHEREOF, I have hereunto sign this affidavit this 27 day th

February 2027, in Quezon City, Metro Manila.

_______________________
Affiant

SUBSCRIBED AND SWORN to before me this 27 day February 2027, in

th

Quezon City, Metro Manila, affiant known to me to be the same person who
executed the foregoing affidavit, and exhibited to me her _______________________,
as competent proof of her identity.