Republic of the Philippines ……………)

Capas, Tarlac…………………) S. S.

AFFIDAVIT OF DISCREPANCY
(ONE AND THE SAME PERSON)

I, MARIBETH PANGILINAN PABALAN, married, of legal age, Filipino, with

residence and postal address at Brgy. Estrada, Capas, Tarlac, after having been duly
sworn to in accordance with law, hereby depose and state: That-

1. My Brother ONOFRE DE JESUS PANGILINAN JR. was born to SPS.

ERLINDA LASCANO DE JESUS and ONOFRE GUIWA PANGILINAN
SR. on July 29, 1972 and was given the name “ONOFRE DE JESUS
PANGILINAN JR.” as evidenced by his Certificate of Live Birth which is
attached herein as ANNEX “A”;
2. Unfortunately, my brother passed away last August 04, 2022 in Capas, Tarlac
which is attached herein as ANNEX “B”;
3. When my mother gave birth to my brother, they decided to give him the name,
“ONOFRE DE JESUS PANGILINAN JR.”;
4. However, in the record of the TARELCO II the said name of my late brother was
“ONOFRE DE JESUS PANGILINAN” and not “ONOFRE DE JESUS
PANGILINAN JR.”;
5. The true and correct name of my late brother is “ONOFRE DE JESUS
PANGILINAN JR.” as indicated in his Certificate of Live Birth and to his
Certificate of Death;
6. I thus assert that based on the foregoing facts and records in my possession, that
“ONOFRE DE JESUS PANGILINAN”, and “ONOFRE DE JESUS
PANGILINAN JR.”, both refer to one and the same person;
7. I am executing this Affidavit to attest to the truth of the foregoing, and for
whatever other legal intent and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of

________________, in _______________________________.

MARIBETH PANGILINAN PABALAN

Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of _____________

in ____________________________, the affiant having satisfactorily established her
identity to me by exhibiting her National ID with ID No. 5967-9129-0647-1094, for her
personal identification.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2022.