REPUBLIC OF THE PHILIPPINES )

PROVINCE OF PAMPANGA )S S
MUNICIPALITY OF GUAGUA )
x____________________________x

AFFIDAVIT OF DISCREPANCY

I ______________________________________ of legal age, Filipino citizen and

with residence at ____________________________________________, after having
been duly sworn in accordance with law, hereby depose and state.

That I was born on _________________________________________________ in

________________________________________________________ from parents
_________________________________________________________________.

That I have been using said information’s since childhood for as long as
I can remember since I acquired knowledge in all of my public and private
dealings thus appeared in my records.

That recently when I requested for a copy of my

_______________________________________________________, I found out that my
____________________________________ was erroneously entered as
___________________________________________, when in fact it should have been
___________________________________ as evident by my birth certificate and other
related documents.

That I am executing this Affidavit to correct such Discrepancy committed

out of inadvertence and to further claim that
______________________________________________________________________________
_____________________________ refer to one and same person.

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

of _______________________ 2021 at Guagua, Pampanga.

____________________________
Affiant

SUBSCRIBED AND SWORN before me this _________ day of

_____________, 2021 at Guagua, Pampanga.

Doc No.: __________

Page No.:__________
Book No.: _________
Series of __________