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    Date of Birth - Affidavit of Discrepancy

    Uploaded by

    Illia Manaligod
    Correction of date of birth.

    Copyright:

    © All Rights Reserved
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    Date of Birth - Affidavit of Discrepancy

    Uploaded by

    Illia Manaligod
    31 views2 pages
    Correction of date of birth.

    Original Title

    Date of birth- Affidavit of discrepancy

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    © © All Rights Reserved

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    Correction of date of birth.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    31 views2 pages

    Date of Birth - Affidavit of Discrepancy

    Uploaded by

    Illia Manaligod
    Correction of date of birth.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    REPUBLIC OF THE PHILIPPINES )

    Province of Tarlac ) S.S.


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

    AFFIDAVIT OF DISCREPANCY

    I, ANNALIZA L. TIMOTEO, of legal age, Filipino, married, and a resident


    of Barangay Mabilog, Concepcion, Tarlac, Philippines, having been duly sworn
    in accordance with law, hereby depose and state:

    1. That I am the sibling of EDILBERTO A. LOPEZ, who died on January


    29, 2021, at the Tarlac Provincial Hospital, Tarlac City, Tarlac, a copy
    of his Death Certificate issued by the Municipal Civil Registrar of
    Concepcion, Tarlac, is hereby attached as Annex “A”;

    2. That I found out in the Certificate of Live Birth issued by the Philippine
    Statistics Authority (PSA) of EDILBERTO A. LOPEZ (DECEASED), his
    date of birth, as shown and appearing therein is “December 23,
    1961”, instead of the deceased’s true and correct date of birth,
    “December 26, 1962”, as evidenced by the deceased’s Death
    Certificate issued by the Municipal Civil Registrar of Concepcion,
    Tarlac;

    3. That the discrepancy was not intentional but the same was only the
    result of an honest clerical mistake due to inadvertence at the time of
    entry;

    4. That the EDILBERTO A. LOPEZ (DECEASED) whose birthday is


    reflected as “December 23, 1961” in his Certificate of Live Birth issued
    by the Philippine Statistics Authority (PSA) and the EDILBERTO A.
    LOPEZ (DECEASED) whose birthday is reflected as “December 26,
    1962”, in his Death Certificate issued by the Municipal Civil Registrar
    of Concepcion, Tarlac, refers to one and the same person, which is my
    deceased brother; and

    5. As such, I am executing this Affidavit to attest to the truth of the


    foregoing narrated facts, and for any other legal purpose that this
    Affidavit may serve.

    IN WITNESS WHEREOF, I have signed this affidavit on


    _________________________ at Concepcion, Tarlac, Philippines.

    ANNALIZA L. TIMOTEO
    Affiant

    SUBSCRIBED AND SWORN to before me, this _______________________ at


    Concepcion, Tarlac, Philippines, by the Affiant whom I have identified through
    her PhilHealth I.D. No. 07-202223408-1, who is the same person who personally
    signed and executed this Document.

    Doc. No. ______;


    Page No. ______;
    Book No.______;
    Series of 2021.

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