Republic of the Philippines )

________________ ) S.S.

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, ________________________ and ____________________________ , both of

legal ages, Filipino citizens and residents of Brgy. Wenceslao, Caba, La Union, after having
been duly sworn to in accordance with law, do hereby depose and state:

THAT we personally know _____________________________________, who was

born in Caba, La Union on JANUARY 28, 1969 of his
parents___________________________________________

THAT their family was our neighbors and friends in Caba, La Union;

That his fact of birth was duly recorded with the Office of the Local Civil Registrar of
Caba, La Union;

That in his Personal Data Record filed with the office of the Social Security System, his
first name was erroneously written as “_______________” instead of his true and correct first
name which is “__________________” as appearing in his Certificate of Live Birth;

This error may have been caused by the inadvertence of the person who prepared and
process his SSS including his Personal Data Record;
That in all of his pertinent documents which he had used, he used his true and correct
first name which is “________________”;

The names _____________________________________ and

_______________________________ refer to one and the same person;

We are not related by affinity or consanguinity to the above mentioned person; and

That we are executing this Affidavit of Discrepancy to attest to the truth of the foregoing
facts and to explain the discrepancy in the SSS PERSONAL DATA RECORD of
_______________________________, as regards to his true first name.

IN WITNESS WHEREOF, we have hereunto set our hands this February 7, 2019 in
Caba, La Union, Philippines.