REPUBLIC OF THE PHILIPPINES }

CITY OF CAGAYAN DE ORO } S.S.

AFFIDAVIT OF DISCREPANCY

I, ______________________, of legal age, single, Filipino and a resident of

_________________________, Philippines, after having been duly sworn to an
oath in accordance with law, hereby depose and say, that:

1. I am the same ____________________, who was born on

_______________ as stated in my certificate of birth;
2. The name indicated on my Examination Records of the Civil Service
Commission Regional Office X is under “______________”;

3. The name “_____________” and “________________” refer to one and the

same person, the herein affiant;

4. I am executing this affidavit to attest to the truth of the foregoing statements,

in order to correct the entry indicated on the Examination Records of the Civil
Service Commission Regional Office X and in order to facilitate the issuance of
my Civil Service Certificate of Eligibility, and for whatever legal purpose/s this
may deem served.
IN WITNESS WHEREOF, I have hereunto set my hand this
_______________ at Cagayan de Oro City, Philippines.

__________________________
Affiant
____________________

SUBSCRIBED AND SWORN TO before me this ________________ at

Cagayan de Oro City, Philippines.

Doc. No. ___:

Page No. ___:
Book No.___:
Series of 2020.