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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) Sc.


MUNICIPALITY OF TUBAO )
x-------------------------x

AFFIDAVIT OF DISCREPANCY
I, EUFEMIA QUINIONES LARON, of legal age, Filipino, married
and a resident of Poblacion, Tubao, La Union, after having been duly
sworn to in accordance with law, do hereby declare and say that:

1. That I was issued a Voters ID issued by the Office COMELEC


and my name therein entered is EUFEMIA Q. LARON;

2. That I was issued a Check issued by DSWD, Tubao La union, my


name was erroneously entered as ANA which is my nickname;

3. That due to the above-described reason, there is now a


discrepancy in my first name as appearing in the Check and my
Voters ID;

4. In view of the foregoing, EUFEMIA Q. LARON and ANA Q.


LARON pertains to me as one and the same person;

5. I categorically state that I will be using EUFEMIA as my first


name and not ANA in all of my official records; as such, my
complete and correct name should appear as EUFEMIA Q.
LARON;

6. That I am executing this Affidavit to attest to the truth of


all the foregoing facts, to support my passport application
and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th


day of October 2016 at Tubao, La Union, Philippines.

EUFEMIA QUINIONES LARON


Affiant

SUBSCRIBED AND SWORN to before me this 18th day of October


2016 at Tubao, La Union by the affiant appearing personally and who is
known to me to be the same person who executed this affidavit.

ATTY. JOONEE RANDYL E. RIVERA


Notary Public until December 31, 2016
Doc. No. 455; Aspiras Highway, Francia Sur, Tubao, La Union
Page No.: 91; Roll No. 61766, TIN 929-347-628
Book No.: IX; PTR No. 643362; 01-04-16, Tubao, LU
Series of 2016. IBP Life Member No. 012553; 01-02-14, SFLU
Commission No. ANC-2014-11