Affidavit of Discrepancy in Name


an affidavit used to clear any discrepancy which may arise from official documents bearing names not stated on birth certificate

I, _____________________, of legal age, married, and with address at ______________________________________________________, under oath, state:

1. THAT my name is ____________________ as stated and registered in my birth certificate issued by office of the Civil Registry of ______________________. A copy of my birth certificate is hereto attached as ANNEX “A”;

2. THAT the name ___________________also appears in my passport which was issued based on the data appearing in my birth certificate. A copy of the page of my passport where my name and picture appears is hereto attached as ANNEX “B”;

3. THAT since childhood, my friends and acquaintances call me ________and thus since then I have been accustomed to using the name ____________________in my personal records, transactions and communications;

4. THAT the name ____________________ and _____________________ refer to one and the same person, the herein Affiant;

5. THAT I am executing this Affidavit to attest to the truth of the foregoing facts and to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this _________________ at Makati City.



SUBSCRIBED AND SWORN to before me this _______________ at Makati City, Affiant exhibiting to me his Passport bearing No. ______________________________ issued at ______________ on _________________.

Doc No. ________;

Page No. _______ ;

Book No. _______;

Series of ________.