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Republic of the Philippines]

Santa Cruz, Laguna ] s.s.

AFFIDAVIT OF DISCREPANCY
I RENARIA REBONG MANDI, of legal age, Filipino, married and resident of
Phase 1 Block 6 Lot 3, Opal Street, Lynville Homes, Bagumbayan, Santa Cruz,
Laguna after having been sworn in accordance with law, hereby depose and
state that –

1. In the following documents and identification cards, the following names


which refer to one and the same person (the undersigned), appear as
follows –

MANDI, RENARIA REBONG – Driver License No. D12-98-045891


Tax ID. No. (TIN) 291-406-759-000
Voter ID No. 3430-0020A-J1360RRM20001-7
REYNARIA P. REBONG – Social Security System ID No. 03-3731011
REYNA RIA PABALAN REBONG – Diploma (Elem./H.S./College)
RENARIA PABALAN REBONG – Certificate of Live Birth

2. Therefore, the correct maiden name of the undersigned is RENARIA


PABALAN REBONG as appearing on her Certificate of Live Birth. The
version RENARIA REBONG MANDI as currently in use by undersigned, is
due to the fact of her marriage to Mendino J. Mandi, Jr., on 21 April 2002.
Those versions appearing in the school records of undersigned and in the
SSS ID Card are honest clerical errors.

3. Undersigned executed this affidavit to attest to the fact that the names
appearing above refer to one and the same person, RENARIA REBONG
MANDI.

IN WITNESS WHEREFORE, I hereto affixed my signature this 17th day of


September 2016 in Santa Cruz, Laguna.

RENARIA REBONG MANDI


Affiant

SUBSCRIBED AND SWORN to before me this 17th day of September 2016


by the affiant who exhibited to me her Driver License No. D12-98-045891
issued at LTO Pila District Office, Pila, Laguna, valid until 13 October 2015.

Doc. No. _____; A T T Y. E M M A N U E L E . S A N D I C H O


Page No._____; NOTARY PUBLIC, COMMISSION UNTIL 31 DEC. 2016
Book No._____; NOTARY PUBLIC FOR THE PROVINCE OF LAGUNA
Series of 2016. PER NOTARIAL COMMISSION SP. PROC. NO. 164(15)
BP O.R. No. 995689, 04 January 2016, Laguna Chapter
PTR O.R. No. 2967138, 04 January 2016, Laguna
Roll No. 42246, admitted to practice law on 9 May 1997
MCLE Compliance No. V-0015412, dated 9 March 2016