REPUBLIC OF THE PHILIPPINES)
CITY OF ZAMBOANGA)
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AFFIDAVIT OF DISCREPANCY
I, NAME, of legal age, single, Filipino, and currently residing at ADDRESS, after
having been duly sworn to in accordance with law, hereby depose and state:
1. That I am executing this affidavit to address a discrepancy regarding the middle name of
my mother as reflected in my school records with Central Sulu College located at Siasi,
Sulu, and my official civil registry records;
2. That in my school records, my mother’s middle name, my birth place and the day of my
birth date are incorrectly recorded as follows:
Mother’s Middle Name: “BAKLAYAN”
Birth Date: “NOVEMBER 8, 2001”
Birth place: “LOCAL SUBAH BUAYA, SIASI, SULU”
3. That my correct and true personal details that reflected in my PSA-issued Birth
Certificate are as follows:
Mother’s Middle Name: “SAKLAYAN”
Birth Date: “NOVEMBER 1, 2001”
Birth place: “SOUTH LAUD, SIASI, SULU”
4. That I am executing this affidavit to attest to the accuracy of my mother's middle name as
indicated in my PSA-issued Birth Certificate and to clarify the discrepancy for any
corrections or verifications required by my school or other relevant authorities;
5. That I am willing to provide supporting documents, including my PSA-issued Birth
Certificate and other pertinent records, to support the accuracy of the information stated
herein;
IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of December 2024,
at the city of Zamboanga, Philippines.
NAME
Affiant
SUBSCRIBED AND SWORN TO before me this 6th day of December 2024, at the city
of Zamboanga, Philippines.
Doc. No.
Page No.
Book No.
Series of 2024.
