Republic of the Philippines )

Camiling, Tarlac ) S.S.

AFFIDAVIT OF DISCREPANCY
I, RICKY BOY SIOJO BALDELOMAR, of legal age, married, Filipino citizen,
and a resident of Barangay Surgui 1st, Camiling, Tarlac, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state THAT:

1. I was born on August 16, 1983 in Sampaloc, Manila, Philippines to Spouses

Ricardo Gabriel Baldelomar and Maximina Medrano Siojo;

2. When I secured a copy of my Certificate of Live Birth from the National

Statistics Office, Manila (now Philippine Statistics Authority), and after
scrutinizing the same, I discovered that my recorded name is RICKY BOY
SIOJO BALDOLEMAR, instead of RICKY BOY SIOJO BALDELOMAR.
Also, the recorded name of my father appearing therein is RICARDO
GABRIEL BALDOLEMAR, instead of RICARDO GABRIEL BALDELOMAR
as recorded in my Baptismal Certificate and Certificate of Marriage. Hence,
the discrepancies;

3. I am executing this affidavit to attest to the fact that the names RICKY BOY
SIOJO BALDOLEMAR, as recorded in the said Certificate of Live Birth, and
RICKY BOY S. BALDELOMAR, as recorded in the said Baptismal
Certificate and Certificate of Marriage, refers to one and the same person,
and that is me;

4. Also, I am executing this affidavit to attest to the fact that the names
RICARDO GABRIEL BALDOLEMAR, as the father of Ricky Boy Siojo
Baldolemar appearing in the said Certificate of Live Birth, and RICARDO G.
BALDELOMAR, as the father of Ricky Boy S. Baldelomar in the said
Baptismal Certificate and Certificate of Marriage, refers to one and the same
person, and that is my father;

5. Finally, I am executing this Affidavit to attest to the truth of the foregoing

statements and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 24th day of

July, 2017 at Camiling, Tarlac, Philippines.

RICKY BOY S. BALDELOMAR

Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicated

above. Affiant exhibited to me his Unified Multi-Purpose ID Card with CRN-0111-
6596127-4 issued by the Social Security System of the Philippines.

Doc. No.:_______;
Page No.:_______;
Book No.:_______;
Series of 2017.