REPUBLIC 

OF THE PHILIPPINES)
CITY OF PARAÑAQUE ) S.S.
x-------------------------------------------x
  
AFFIDAVIT OF DISCREPANCY RE: ONE AND THE SAME PERSON

         I, __________________________________ of legal age, Filipino, and a resident of

_________________________________________, after having been duly sworn to in
accordance with law, depose and state THAT:

1. My complete and legal name is ____________________________ and born on

________________________________;

2. In my Certificate of Live Birth and other government records, it is stated

that my true and correct name is ______________________________;

3. That upon checking my record at Philippine Overseas Employment

Administration (POEA) my name as appearing therein is
____________________________________________________;

4. That I erroneously typed and/or recorded my name upon filling out the
e-registration form of POEA, and it should be corrected to
_____________________________________________;

5. That the erroneous name ___________________________________ as

recorded at the POEA and my true and correct name
_____________________________________ as recorded at Philippine Statistics
Authority (PSA) are all belonging to one and the same person, the herein
affiant; and

6. As such, I am executing this Affidavit to attest to the truth of the

foregoing and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this day of

___________________ in Parañaque City, Metro Manila, Philippines.

_________________________________
AFFIANT
 
SUBSCRIBED AND SWORN to before me, this day of _______________ in
Parañaque City, by the affiant who has exhibited to me his/her
_____________________ with No. _____________________________________ as competent
proof of his identity.

WITNESS MY HAND AND SEAL

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 202__.