Anda di halaman 1dari 1

REPUBLIC OF THE PHILIPPINES ) CITY OF ANGELES ) -s.s.

AFFIDAVIT I, ADELAIDA TANEDO QUIAMBAO of legal age, Filipino, married, with residence and postal address at # 2074 Kuliat Street, Angeles City, Pampanga, Philippines, after having been duly sworn to in accordance with law, hereby depose and say, that: 1. I am the legitimate daughter of the Spouses Romulo Tanedo (D) and Felicidad Mangune Tanedo (D), born on 20 February 1949 in Panalicsican Concepcion, Tarlac, Philippines. I am applying for a United States of America Visa with the U.S. Embassy/Consulate. In the said application, my date of birth was inadvertently indicated as 14 January 1949. A copy of the said lettercorrespondence from the U.S. National Visa Center (NVC) indicating such date is herein attached and made an integral part hereof as Annex A Said error or discrepancy in my application and birth certificate must have been caused by mistake or inadvertence. One of the requirements for the United States of America Visa is a certified true copy of my birth certificate from the National Statistics Office (NSO). Pursuant to such requirement, I requested for a copy of my birth certificate with the NSO, City of San Fernando, Pampanga, and my date of birth is written as 20 February 1949, which is my true and correct birth date. A copy of said birth certificate is attached hereto as Annex B. I have executed this affidavit to attest to the truth of the foregoing, and to serve as a supporting document, to maintain that my true and correct date of birth is 20 February 1949 instead of 14 January 1949, in accordance with the Certificate of Live Birth issued by the NSO, and for any legal purposes it may serve.

2.

3. 4.

5.

6.

IN WITNESS WHEREOF, I have hereunto set my hand this __ th day of February 2012 in Angeles City, Philippines. ADELAIDA TANEDO QUIAMBAO Affiant SUBSCRIBED AND SWORN to before me this __ th day of February 2012 in Angeles City, Philippines, by Adelaida Tanedo Quiambao, personally known to me to be the same person who personally signed before me the foregoing Affidavit and acknowledged that he executed the same. Doc. No. ___; Page No.___; Book No.___; Series of 2012.

Anda mungkin juga menyukai