Province of____________________) S.S.
City/Municipality of_____________)
AFFIDAVIT OF DISCREPANCY
I, LUCRESIA MALDITA, of legal age, married, Filipino and a resident of _____________, Philippines having been duly sworn I accordance with law, hereby depose and state:
1. That on _______________, I was issued a NBI ID with ID number _____________ in which my true surname MALDITA was stated;
2. That before the expiration of the aforementioned NBI ID on ______________, I had applied with NBI Makati in ______________ for the issuance of a new NBI ID and on ______________, I was issued a new NBI ID with ID no. _______________;
3. However, in the said new NBI ID my surname had been erroneously misspelled as MALDITO;
4. That I execute this Affidavit of Discrepancy to attest to the truth of the foregoing circumstances and to explain the discrepancy in my NBI ID with regards to my surname.
IN WITNESS WHEREOF, I have hereunto set my hands this _____________, at ______________, Philippines.
Subscribed and Sworn to before me this _____________ day of 20___, Affiant exhibiting his/her Residence Certificate No. ________________ issued at ____________________ on ____________________.
Notary Public
Until Dec 31, 2011
Address___
Attorney's Roll No.___
IBP Roll No.___
PTR Receipt No.___
Until Dec 31, 2011
Address___
Attorney's Roll No.___
IBP Roll No.___
PTR Receipt No.___
Doc. No.___
Page No.___
Book No.___
Series of ___
