REPUBLIC OF THE PHILIPPINES)

__________________________________) S.S.

AFFIDAVIT OF EXPLANATION

I, ____, of legal age, single, Filipino and a resident of ____, after being sworn in
accordance with law, hereby depose and state that –

1. I was born _______;

2. I am a bearer of a Philippine Passport issued by the Department of

Foreign Affairs ___ with passport number ___ and valid until ____;

3. However, there were erroneous entries in aforesaid passport to wit:

- my middle name is __
- my place of birth is incorrectly entered as ____;

4. I was not able to immediately report the errors to the DFA because I
thought it would be okay to effect the changes or corrections upon renewal of my
passport and I was already leaving for work abroad during that time;

5. Finally, I am executing this affidavit to attest the truth and veracity of

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

6. Affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_________________________, at ___

Affiant

SUBSCRIBED AND SWORN to before me, this ____________________ at

City of San Fernando, Pampanga, affiant exhibiting to me his Passport No.
______ bearing his photograph and signature as competent evidence of his
identity.