Republic of the Philippines )

Province of Leyte ) SS
City of Tacloban )

AFFIDAVIT TO CORRECT
SPELLING OF MIDDLE NAME

I, DOLORIA GLOBA PUCYUTAN, of legal age, Filipino, married and a resident of

Brgy Bito Abuyog Leyte, after having been sworn according to law, hereby depose and
state: THAT---

1. I am the mother of ANALYN GLOBA PUCYUTAN , who was born on 26 October

2014 in Abuyog Leyte;

2. There is an innocuous error in the spelling of her middle name/maternal

surname appearing in her birth certificate;

3. It should have been spelled as GLOBA, not GLOBAL.

6. I am executing this affidavit to attest to the truth of the foregoing facts to make
the necessary correction of her middle name/maternal surname from GLOBAL to GLOBA.

IN WITNESS WHEREOF, I have hereunto set my hand this 16 November 2019 at

Tacloban City, Philippines.

DOLORIA G. PUCYUTAN
Affiant/Mother

SUBSCRIBED AND SWORN to before me this 16 November 2019 in Tacloban City

by Doloria G. Pucyutan, personally known to me, who is the same person who personally
signed before me the foregoing affidavit and acknowledged that she executed the same.

Doc. No. ____

Page No. ____
Book No. 58
SERIES OF 2010