Republic of the Philippines )

Province of Cavite ) S.S.

City of Carmona )

AFFIDAVIT OF DISCREPANCY

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

Carmona, Cavite, after having been duly sworn to in accordance with law,
hereby depose and state:

1. That, I am the biological father of ___________________

2. That, the Certificate of Live Birth of _________________with

Local Civil Registry No. _______________, as shown in the
attached document, states the following details:

___________________________

3. That, the name that I have known and have been using since
birth is _____________________ as shown in the attached
supporting papers;

4. It is my understanding that the discrepancy arose due to

typographical error.

5. That, I am executing this Affidavit to attest to the truth of

the foregoing facts in connection to __________________
application for Marriage License and to use the same for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

December 7, 2023 at Carmona, Cavite.

Affiant

SUBSCRIBED AND SWORN TO, before me this December 7, 2023

at Carmona, Cavite, affiant personally appeared and exhibiting to me the
above mentioned Identification Card as competent proof of her identity.