Republic of the Philippines)

Quezon City )ss.

AFFIDAVIT OF DISCREPANCY IN NAME

I, NELIA BANDALARIA SARA, Filipino, of legal age, Married to PRIMO ZARA
with residence and postal address at Block 5 Lot 57 GSIS, Brgy. Manggahan,
Rodriguez, Rizal, after being sworn in accordance with law do hereby depose and state,
that:

1. THAT my name is NELIA BANDALARIA ZARA as stated and registered in

our Marriage Contract issued by the Office of the Municipal Civil Registrar of
Taal, Batangas ;

2. THAT since I was married the name that I am using in all my government ID
was NELIA BANDALARIA SARA;

3. THAT the name NELIA BANDALARIA SARA and NELIA BANDALARIA

ZARA refer to one and the same person, the herein Affiant;

4. THAT I am executing this affidavit to attest the truthfulness of the above and
to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of

_________ 2017 in Quezon City, Philippines.

NELIA BANDALARIA SARA

Affiant

SUBSCRIBED AND SWORN to before me this _____ day of

__________________ 2017 in Quezon City, affiant exhibited to me her Social Security
System ID with No. 03-3500401-4.

NOTARY PUBLIC

Doc No. _____

Page No.____
Book No.____
Series of 2017.