Republic of the Philippines…..

)
City of Tagum City.……………….)S.S.
Province of Davao del Norte..)
X------------------x

AFFIDAVIT OF DISCREPANCY

I, ROMEO PAROGROG DANO, of legal age, Filipino, a resident of Purok,

4, La Filipina, Tagum City, Davao del Norte, after being duly sworn to in
accordance with the law, hereby depose and say THAT:
1. My name is ROMEO PAROGROG DANO, as stated and registered
in my birth certificate issued by the Office of the Philippine Statistic
Authority. A copy of my birth certificate is hereto attached as
ANNEX “A”;

2. In all my pertinent document which I had used, to include my

scholastic records, and marriage contract, I erronouesly used my
middle name “PARUGRUG”;

3. My true and correct middle name is “PAROGROG” as appearing in

the same Certificate of Live Birth.

4. I am executing this Affidavit to attest to the truth and veracity of

the foregoing statements and to apprise the proper authorities
concerned on the matter for their information, guidance, and for
whatever legal purpose/s this may serve best.

IN WITNESS WHEREOF, I have hereunto set my hand this

_____________, at ______________, Philippines.

ROMEO PAROGROG DANO

Affiant
Valid ID No. __________________

Signed in the presence of _______________ and __________________.

SUBSCRIBED AND SWORN to before me _____________ in

_________________, Philippines, and I hereby certify that I have
personally examined the affiant and I am satisfied that she has
voluntarily executed and understood the contents of this Affidavit.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of _____.

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