REPUBLIC OF THE PHILIPPINES )

City of Baguio) S.S.

AFFIDAVIT OF DISCREPANCY IN NAME

I, MARIA CLARA IBARRA, of legal age, married, and with address at Upper Pinget, Baguio City, under
oath, state:

1. My name is Maria Clara Ibarra as registered in my birth certificate issued by office of the Civil
Registry of La Trinidad, Benguet. A copy of my birth certificate is attached as ANNEX “A”.

2. The name Maria Clara Ibarra also appears in my passport which was issued appearing in my birth
certificate. A copy of the page of my passport where my name and picture appears is attached as
ANNEX “B”.

3. Since childhood, my friends call me Maria Clara Ibbara, since then I have been accustomed to
using the name Maria Clara Ibarra in my personal records, transactions and communications.

4. The name Mary Claris Ibbara and Maria Clara Ibbara refer to one and the same person.

5. I am executing this Affidavit to attest to the facts and to use the name for any legal purposes.

I affix my signature this 31st of January 2024 at La Trinidad, Benguet.

________________________

Affiant

Subscribed before me this 31st of January 2024 at La Trinidad, Benguet. Affiant presents to me her Passport
bearing No. 1234567890 issued at DFA SM Baguio on December 10, 2022.

Doc No. ________;

Page No. _______ ;

Book No. _______;

Series of ________.