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Affidavit of Discrepancy in Birthyear and Lastname

Sample Affidavit of Discrepancy in Birthyear and Lastname for use with various government agencies like Pag-ibig, etc.

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Consigliere Tadili
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248 views1 page

Affidavit of Discrepancy in Birthyear and Lastname

Sample Affidavit of Discrepancy in Birthyear and Lastname for use with various government agencies like Pag-ibig, etc.

Uploaded by

Consigliere Tadili
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

PROVINCE OF CAGAYAN
MUNICIPALITY OF BUGUEY

)
) S.S.
)

AFFIDAVIT OF DISCREPANCY
I, NESTOR C. BALDIVINO, of legal age, married, Filipino and a resident of
Villagracia, Buguey, Cagayan, after having been duly sworn to in accordance with
law deposes and states:
That I was born on February 9, 1956 in Buguey, Cagayan and the fact of my
birth has been duly recorded in the Office of the Civil Registrar of Buguey, Cagayan
and the entries are as follows:
Name
Place of Birth
Date of Birth

:
:

Nestor C. Valdivino
:
Alucao, Buguey, Cagayan
February 9, 1956

as appearing in my Certificate of Birth, copy attached as Annex A and forms part


hereof;
That in my service records with National Irrigation Administration, my birth
date was erroneously stated as February 13, 1957, copy attached as Annex B
and forms part hereof;
That also in my application for provident benefits claim (APB) with Pag-ibig,
my birthdate was also erroneously indicated as February 13, 1957, copy attached as
Annex C and forms part hereof;
That my true and correct date of birth is February 9, 1956;
That I am executing this affidavit to attest to the truth of the foregoing so
that my record with Pag-ibig will be corrected and for other legal purposes.
IN WITNESS WHEREOF, I have hereunto set my hand this 2nd day of June
2016 at Buguey, Cagayan.
NESTOR C. BALDIVINO
Affiant
DL# B03-00-019011
Issued on January 13, 2016
Issued at Aparri, Cag.
SUBSCRIBED AND SWORN TO BEFORE ME, this 2nd day of June 2016 at
Buguey, Cagayan, affiant exhibited to me his competent proof of identity.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2016.

ERNANI T. TADILI
NOTARY PUBLIC
Until December 31, 2016
IBP OR No. 946905
PTR OR No. 6485838
Attorneys Roll No. 64233
MCLE Compliance No. V-0013985
Email add: etadili@gmail.com
CP #. 0947-323-3877

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