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Affidavit of Discrepancy Last Name

This affidavit details discrepancies in the affiant's name and date of baptism on their certificate of live birth. Specifically, the affiant's name on their birth certificate does not match the name they have used their whole life. Additionally, the date of baptism listed is incorrect by being in 1992 instead of the actual date of 1993. The affiant is filing this affidavit to correct the errors and clarify their true name and baptism date for legal purposes.

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Raiza Khey Laserna Llorico
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368 views1 page

Affidavit of Discrepancy Last Name

This affidavit details discrepancies in the affiant's name and date of baptism on their certificate of live birth. Specifically, the affiant's name on their birth certificate does not match the name they have used their whole life. Additionally, the date of baptism listed is incorrect by being in 1992 instead of the actual date of 1993. The affiant is filing this affidavit to correct the errors and clarify their true name and baptism date for legal purposes.

Uploaded by

Raiza Khey Laserna Llorico
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

CITY OF ROXAS…………………)S.S.

AFFIDAVIT OF DISCREPANCY IN NAME

I, _________________, of legal age, Filipino, single, and a resident of


Brgy. Esperanza, Jamindan, Capiz after having duly sworn to in
accordance with law hereby depose and state THAT:

1. I was born out of wedlock on 18 December 1992 in Brgy.


Esperanza, Jamindan, Capiz and my biological mother is
___________________. A machine copy of my Certificate of
Live Birth is hereto attached and marked as ANNEX “A”.

2. Since childhood, I have been accustomed and known as


_________________ in my personal records, transactions and
communications.

3. Lately, when I secured a copy of my Certificate of Live Birth in


Saint Sebastian Parish, Jamindan, Capiz, I discovered that my
name appearing therein is _________________ instead of my
true and correct name, _____________________.

4. Further, I have noticed that there is a clerical error on the


Date of Baptism as contained in my Certificate of Live Birth.
The date appearing thereon is February 03, 1992, instead of
the true and correct date, February 03, 1993.

5. I am executing this Affidavit of Discrepancy to attest to the


truth of the foregoing facts, to explain the discrepancy in my
Baptismal Certificate, for the correction of my last name and
date of baptism as entered into in the same Baptismal
Certificate, and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


___________________ at Roxas City, Capiz.

_______________________________
Affiant

SUBSCRIBED AND SWORN to before me this ___________________ at


Roxas City, Capiz, afftiant exhibiting to me her Voter’s ID No.

Doc. No._______
Page No._______
Book No._______
Series of 2019.

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