Affidavit of Reconciliation of Birth Data

Affidavit of Reconciliation of Birth Data

Use this free template – Affidavit of Reconciliation of Birth Data. This affidavit corrects a misspelling in the Affiant’s name with government agencies.

To use this free sample form, simply fill out the blank spaces and edit the document with the relevant information, print it out, and sign below.

I, ___________________, of legal age, single, Filipino citizen, and with residence at _______________ after having been sworn in accordance with the law, do hereby depose and state that:

I was born to Spouses and __ of Taguig City on July 11, 1985;

In the birth certificate which I obtained only recently, my family name is spelled as “____” instead of “_____” which I have I have been used in my school records, SSS, BIR, and other public documents. A copy of the said birth certificate which indicated my family name as “___” is hereto attached for reference;

The names _____ and _______ belong to one and the same person, the undersigned herein;

That I am executing this affidavit in order to attest to the truth of the foregoing circumstances and for the purpose of setting the records straight and declaring that ________ and _____________ refer to one and the same person.

IN WITNESS WHEREOF, I have hereunto affixed my signature on this day of _____, 20 _ in _____________.


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