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REPUBLIC OF THE PHILIPPINES}

STA. CRUZ, LAGUNA.....................}S.S.

AFFIDAVIT OF DISCREPANCY

I, VINCENT ABUEL DORADO, Filipino, of legal age, single, and a resident of


Brgy. Ibabang, San Roque, Liliw, Laguna, after having been duly sworn to in
accordance with law, hereby depose and state:

1. That my mother, ROSELLE ABUEL DORADO died on December 10, 2018


as evidenced by her Certificate of Death;

2. That my father was a member of Serbisyong Tama Health Card or Blue Card;

3. That as the son of my deceased father, I seek financial assistance;

4. That in my Certificate of Live Birth, my name appears as LEO ANTENOR


MARCELO which is the true and correct name;

5. That in my Voter’s ID my name was erroneously registered as LEO


ANTHONY ANTENOR MARCELO;

6. That the names LEO ANTENOR MARCELO as appearing in my Certificate of


Live Birth and LEO ANTHONY ANTENOR MARCELO, as appearing in my
Voter’s ID, refer to one and the same person, and that the true and correct
name is that contained in the former;

7. That I am executing this affidavit to attest to the fact of the above


discrepancies and for whatever legal purpose it may serve.

IN TRUTH WHEREOF, I have hereunto set my hand this 8th day of January 2019
at Sta. Cruz, Laguna.

LEO ANTENOR MARCELO


Affiant

SUBSCRIBED and SWORN to before me this 8 th day of January 2019 at Sta.


Cruz, Laguna, affiant exhibiting his Voter’s ID with No. 3430-0037B-K1485LAM10001-7
as proof of his identity.

Doc. No. ____


Page No. ____
Book No. ____
Series of 2019.