Scribd
Upload
144 views1 page

Affidavit

Norberta Lumabong Larino swore in an affidavit that her date of birth is July 20, 1931 as reflected in her senior citizen ID, but the Southern Philippines Medical Center incorrectly listed her date of birth as July 21, 1931 due to a mistake made by a watcher. She affirmed that Norberta Lumabong Larino with a July 20, 1931 date of birth and Norberta Gallardo Larino with a July 21, 1931 date of birth in medical records both refer to herself as the same person. The affidavit was executed to clarify her true date of birth for legal purposes.

Uploaded by

姆士詹
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
144 views1 page

Affidavit

Norberta Lumabong Larino swore in an affidavit that her date of birth is July 20, 1931 as reflected in her senior citizen ID, but the Southern Philippines Medical Center incorrectly listed her date of birth as July 21, 1931 due to a mistake made by a watcher. She affirmed that Norberta Lumabong Larino with a July 20, 1931 date of birth and Norberta Gallardo Larino with a July 21, 1931 date of birth in medical records both refer to herself as the same person. The affidavit was executed to clarify her true date of birth for legal purposes.

Uploaded by

姆士詹
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
You are on page 1/ 1

REPUBLIC OF THE PHILIPPINES)

C I T Y O F D A V A O ) SS.
x- - - - - - - - - - - - - - - - - --x

AFFIDAVIT OF EXPLANATION

I, NORBERTA LUMABONG LARINO, widow, of legal age, Filipino, and a


resident of Tingolo, Malita, Davao Occidental, Philippines, after being duly sworn in
accordance with law hereby depose and say that:

1. I am the same person who caused the execution of this document.

2. My correct Date of Birth is “July 20, 1931” as correctly reflected in my


Senior Citizen’s ID. However, in my medical records with the Southern
Philippines Medical Center (SPMC), my Date of Birth was erroeneously
entered as “July 21, 1931”, due to wrong information given by the watcher.

3. I therefore state under oath that “NORBERTA LUMABONG LARIN” with


“July 20, 1931” Date of Birth in her Senior Citizen’s ID and “NORBERTA
GALLARDO LARINO” with “July 21, 1931” Date of Birth in the SPMC
medical records, refer to me as one and the same person.

4. I am executing this affidavit to attest to the truth of my foregoing statements


and for whatever legal purpose it may serve and apprise the authorities of the
foregoing facts and circumstances.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


_______________ at Davao City, Philippines.

NORBERTA LUMABONG LARINO


Affiant
OSCA ID No. 110653- Mun. of Malita

SUBSCRIBED and sworn to before me, in the City of Davao, this


______________, affiant exhibiting to me his/her competent evidence of identity first
written above below his/her name.

Doc. No. ____


Page No. ____
Book No. ____
Series of 2018.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy