AFFIDAVIT OF DISCREPANCY (TO ESTABLISH SINGLE IDENTITY OF NAMES)
I, LEONORA ATEGA REGODON, Filipino, of legal age, married, with
postal address at P3 #36 A Mabini St. Pacita Complex San Pedro Laguna, after having been sworn to in accordance with law, hereby depose and state:
1. That in my Certificate of Birth, my maiden name was erroneously
written as “ATIGA" instead of my true and correct maiden name of “ATEGA".
2. That my true maiden name is “ATEGA” as appearing in my
Philippine Passport and PRC License for Teacher, a copy of which are hereto attached as Annex “A” and “B” respectively;
3. That in all pertinent documents which I had used, to include that
of my Election Records and GSIS Records, I used my true and correct maiden name of “ATEGA”, copy of which are hereto attached as Annex “C” and Annex “D” respectively;
4. That I assumed the name LEONORA ATEGA, when I signed
official documents and exercised my professional work in government;
5. That in my Marriage Certificate I used my true and correct
maiden name as LEONORA ATEGA, copy of which is hereto attached as Annex “E”;
6. That I am executing this Affidavit of Discrepancy to attest to the
truth of the foregoing facts and to explain the discrepancy in my Certificate of Live Birth, as regards my true last name.
7. That the maiden name LEONORA ATIGA, as appearing in my
Certificate of Live Birth, and LEONORA ATEGA as appearing in my government-issued IDs, refer to one and the same person, which is the undersigned/affiant herein;
8. That I am executing this Affidavit to clear any discrepancy which
may arise from official documents bearing either name LEONORA ATIGA" or “LEONORA ATEGA”. IN WITNESS WHEREOF, I have hereunto affixed my signature this ________ in ____________.
LEONORA ATEGA REGODON
Affiant
SUBSCRIBED AND SWORN to before me this this ________ in
____________ with affiant exhibiting to me her _________.
Doc. No. ____;
Page No. ____; Book No. ____; Series of _____. ANNEX “A” (Philippine Passport) ANNEX “B” (PRC License) ANNEX “C” (Voter’s ID) ANNEX “D” (GSIS ID) ANNEX “E” (MARRIAGE CERTIFICATE)