REPUBLIC OF THE PHILIPPINES )

Province of Laguna ) S.S.

City of Santa Rosa )

AFFIDAVIT OF DISCREPANCY

I, MELVIN CARTECIANO TABELISMA, Filipino, of legal age, married, and

a resident of Santa Rosa City, Laguna. After having been d u l y sworn t o in accordance
with law, hereby depose and say that:

1. I was born on APRIL 15, 1978 to Spouses BERNARDO P. TABELISMA and ARSENIA B.
CARTECIANO.

2. My name, as appearing in my Certificate of live birth issued by PSA erroneously states,

“MELVIN CARTECIANO TABELISMO.”

3. My name, as appearing in my Certificate of Marriage, is “MELVIN CARTECIANO

TABELISMA”

4. My name, as appearing in my Social Security System (SSS) ID, is “MELVIN CARTECIANO

TABELISMA”

5. That during my childhood and adult years, I have been using the name MELVIN
CARTECIANO TABELISMA and had been signing official documents under such name

6. The names “MELVIN CARTECIANO TABELISMO” and “MELVIN CARTECIANO

TABELISMA” belong to one and the same person, the undersigned herein.

7. I am executing this affidavit in order to attest to the truth of the foregoing matters,
for setting the records straight, and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _________ of March, 2024 in
Santa Rosa City, Laguna.

MELVIN CARTECIANO TABELISMA

Affiant
SSS ID NO.04-0912295-8

SUBSCRIBED AND SWORN to before me, this ____ day of March, 2024, affiant exhibiting
to me his competent evidence of identity by way of the following:

NAME GOVERNMENT ISSUED ID

MELVIN CARTECIANO TABELISMA SSS ID NO.04-0912295-8

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