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REPUBLIC OF THE PHILIPPINES)

SANTIAGO CITY) S.S.


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

AFFIDAVIT OF DISCREPANCY IN NAME

I, MEYNARDO DIAZ y MIGUEL, of legal age, married, and with address


at Purok 4, Inanama, Alicia, Isabela, after having been duly sworn to in
accordance with law do hereby deposes and states:

1. THAT, the National Statistics Office, Quezon City issued in my favor a


Certificate of Live Birth[1] wherein my true name was MEYNARDO
DIAZ y MIGUEL;

2. THAT since childhood, I have been accustomed to using the name


MENARDO DIAZ y MIGUEL in my personal records, transactions
and communications;

3. THAT the name “MEYNARDO DIAZ y MIGUEL” and “MENARDO


DIAZ y MIGUEL” refer to one and the same person, the herein Affiant;

4. THAT I am executing this Affidavit to attest to the truth of the


foregoing facts and to use the same for whatever legal purpose it may
serve.

IN WITNESS WHEREOF, I hereunto affix my signature this 14th day of


August 2018 at Santiago City.

MEYNARDO DIAZ y MIGUEL


Affiant
ID No. ASDT646-24

SUBSCRIBED AND SWORN, to before me this 14th day of August,


2018 at Santiago City, together with his identifying evidence required by
these rules, who signed the said instrument in my presence. I further
certify that I have personally examined the affiant and I am convinced that
the same is his own free and voluntarily act and deed.

Doc. No. _____


Page No. _____
Book No. ____
Series of 2018

1
Annex “A” hereof.