Republic of the Philippines)
Province of La Union) S.S.
City of San Fernando)
x - - - - - - - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF DISCREPANCY
I, ANITA DUMAGUIN, of legal age, single, Filipino and a resident
of Santiago Norte, San Fernando City, La Union, Philippines, having
been duly sworn in accordance with law, hereby depose and
state:
1. That in the Certificate of Live Birth as recorded in the
Office of the Civil Registrar of Sta. Maria, Ilocos Sur, it was
stated that my daughter, MAY ANN A. DUMAGUIN, was born at Sta.
Maria, Ilocos Sur and in her Secondary Student Permanent Record
from La Union National High School, it is stated that she was born
at Santiago Norte, San Fernando, La Union, Philippines;
2. That acting on the honest belief that MAY ANN was born at San
Fernando, La Union, had used San Fernando, La Union as her birth
place in all pertinent school records when they processed my
enrollment at DMMMSU-MLIUC;
3. That I am executing this Affidavit of Discrepancy to attest
to the truth of the foregoing facts and to explain the discrepancy
in the Certificates of Live Birth and the Secondary Student
Permanent Record of my daughter, MAY ANN A. DUMAGUIN, as regards to
her place of birth;
4. Further, I am declaring that from this date hereon that she
would be using her true and correct place of birth of Sta. Maria,
Ilocos Sur in all her papers, records and other documents.
IN WITNESS WHEREOF, I have hereunto set my hand this November
10, 2014, at San Fernando City, La Union, Philippines.
ANITA DUMAGUIN
Affiant
Voters ID 3314-0268A-D1857AAD200003-8SUBSCRIBED AND SWORN to
before me, this November 7, 2014, by the Affiant who is personally
known to me and whom I have identified through competent evidence
of identity as noted.
Doc. No. ______;
Page No. ______;
Book No.______;
Series of 2014.
GILBERT RUIZ HUFANA
Notary Public until December 31, 2015
Roll No. 61392 (03.27.2012)
IBP No. 933255 (12.23.2013)
PTR No. 0131447 (01.07.2014)
TIN 920-960-030
