Republic of the Philippines )

Province of Leyte )
Municipality of Inopacan )

JOINT AFFIDAVIT
(OF DISCREPANCY)

We , Winefredo Jomoc and Lucena Peteros of legal ages, married, Filipinos and
residents Brgy. Linao, Inopacan, Leyte , after having been duly sworn to in accordance
with law hereby depose and state:

1. That FATIMA BATION ANTONIO was born on December 07, 1951 as

reflected in her CERTIFICATE OF LIVE BIRTH;

2. FATIMA B. ANTONIO was married to DANILO P. GOLTIANO, thus she is

now bearing the name Mrs. FATIMA A. GOLTIANO

3. We have personal knowledge of the Birth Date of Fatima Goltiano ( or Fatima

B. Antonio when she was yet single) because as friends we exchange
personal details;

4. When Anecita Casidsid ( cousin of Fatima A. Goltiano) filed in her behalf in

the Office of Social Security System, she wrongfully entered the Date of Birth
with the date of December 7,1954;

5. Hence therefore, the record of Social Security System reflects that her Date of
Birth is December 07, 1954 instead of December 07 ,1951 ;

6. There exists a discrepancy on the year from 1951 to 1954;

7. We are executing this affidavit to cause the correction of entries in the record
of Social Security System from December 7,1954 to December 7,1951

8. We attest to the veracity of the foregoing and for whatever legal purposes it
may serve.

IN WITNESS WHEREOF, I hereby affix my signature this June 19, 2023, at

Inopacan, Leyte, Philippines.

WINEFREDO JOMOC LUCENA PETEROS

Affiant Affiant

SUBSCRIBED AND SWORN TO this June 19, 2023 at Inopacan, ,Leyte ,

Philippines .
 Atty. LUCILLE M. TEVES
Notary Public
Doc. No._____; Notarial Commission No, 263-2023-09
Page No._____; Until December 31,2024
Book No._____; Roll of Attorney No. 66995
Series 2023 IBP No. 249420;January 09,2023;Leyte Chapter
PTR No.6791929; January 12,2023, Inopacan,Leyte
MCLE Compliance No. VII on 0006563
TEVES LAW OFFICE
San Antonio St. Inopacan, Leyte