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Affidavit

1. Leonora Atega Regodon filed an affidavit to establish that her maiden name, which was erroneously written as "Atiga" on her birth certificate, is actually "Atega" as shown on her passport, teacher's license, voter ID, GSIS ID, and marriage certificate. 2. She uses her correct maiden name, Leonora Atega, on all official documents and assumes that name for professional purposes. 3. The affidavit is being submitted to clarify any discrepancies between her birth certificate listing her maiden name as "Atiga" versus her correct maiden name of "Atega" on other government-issued IDs.

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Araceli Gloria
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164 views7 pages

Affidavit

1. Leonora Atega Regodon filed an affidavit to establish that her maiden name, which was erroneously written as "Atiga" on her birth certificate, is actually "Atega" as shown on her passport, teacher's license, voter ID, GSIS ID, and marriage certificate. 2. She uses her correct maiden name, Leonora Atega, on all official documents and assumes that name for professional purposes. 3. The affidavit is being submitted to clarify any discrepancies between her birth certificate listing her maiden name as "Atiga" versus her correct maiden name of "Atega" on other government-issued IDs.

Uploaded by

Araceli Gloria
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines )

Province of Bulacan ) S.S.

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)

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