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Affidavit of DIscrepancy

1. Sam L. Milby executed an affidavit to correct a discrepancy in his surname on his birth certificate. 2. His birth certificate erroneously listed his surname as "Melby" instead of his correct surname "Milby". 3. He signed the affidavit to attest to the truth that "Sam L. Milby" and "Sam L. Melby" refer to the same person and to explain the error in his birth certificate.
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0% found this document useful (0 votes)
207 views

Affidavit of DIscrepancy

1. Sam L. Milby executed an affidavit to correct a discrepancy in his surname on his birth certificate. 2. His birth certificate erroneously listed his surname as "Melby" instead of his correct surname "Milby". 3. He signed the affidavit to attest to the truth that "Sam L. Milby" and "Sam L. Melby" refer to the same person and to explain the error in his birth certificate.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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REPUBLIC OF THE PHILIPPINES)

CITY OF TARLAC ) S.S.


x----------------------------x

AFFIDAVIT OF DISCREPANCY

I, SAM L. MILBY, of legal age, Filipino, (single/married/widow) and a resident of


_______________________________, after having been duly sworn to in accordance
with law, depose and state THAT:

1. I was born on 15th day of the October 1960 to spouses Anna Lerma and John Milby;

2. I have been using the name SAM L. MILBY in all my documents and transactions;

3. However, when I obtained a copy of my birth certificate, I discovered that my surname


appearing thereon was erroneously written as "MELBY";

4. The names “SAM L. MILBY” and “SAM L. MELBY” refers to one and the same person;

5. I execute this Affidavit of Discrepancy of Surname to attest to the truth of the foregoing
facts and to explain the discrepancy in my birth certificate with regards my surname.

IN WITNESS WHEREOF, I have hereunto set my hand


this ___________________ in Makati City, Metro Manila, Philippines.

____________________
Affiant
SSS ID No. _____________

SUBCRIBED AND SWORN TO before me this ___________________ in


_________________, Philippines, affiant exhibiting to me his/her competent evidence
of identity by way of __________________ issued at ______________
on __________________.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2013.

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