Republic of the Philippines )

City of (_________________) S.S

x-------------------x

AFFIDAVIT OF CHANGE OF ADDRESS

I, (Name of Affiant), of legal age, Filipino, single/married, and a resident of (Place of

Residence), after being sworn to in accordance with law, hereby depose and state that my
old residential address, to wit:
Old Address
(PLACE OF OLD ADDRESS)

Was on the (Date of Change of Address) changed to:

New Address
(PLACE OF NEW ADDRESS – UNDERLINE)

I am executing this Affidavit to attest to the truth of the foregoing and for whatever legal
purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ______ of _______________ 2024
in __________________, Philippines.

(NAME OF AFFIANT)

SUBSCRIBED AND SWORN TO BEFORE ME this ______ of _______________ 2024 in

__________________, Philippines by (Name of Affiant) who presented his Valid ID with No.
__________________________ was issued/expires on __________________________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2024.