Republic of the Philippines)

Province of___________________) S.S.

City/Municipality of___________)
x - - - - -- - - - - - x

AFFIDAVIT OF DISCREPANCY

I, MEDELAINE PANTIG-ATIENZA, of legal age, Filipino, married and with

office address at Suburban, Brgy. San Jose, Rodriguez, Rizal, Philippines, having been
duly sworn in accordance with law, hereby depose and state:

1. That in my Certificate of Live Birth as recorded in the Office of the Civil

Registrar of Quezon City, Metro Manila, Philippines, my name was
erroneously written as "NEDELAINE JOSON PANTIG instead of my
true and correct name of "MEDELAINE JOSON PANTIG ";

2. That in all pertinent documents which I had used, and in most of my

transactions, I have been using the name of “MEDELAINE JOSON
PANTIG” since my early childhood;

3. It is only when I received the copy of my Certificate of Live Birth that I

discovered that name was erroneously written as "NEDELAINE JOSON
PANTIG”;

4. That I am executing this Affidavit of Discrepancy to attest to the truth

of the foregoing facts and to explain the discrepancy in my Certificate of
Live Birth, as regards my true first name.

IN WITNESS WHEREOF, I have hereunto set my hand this___________, at___________,

Philippines.

MEDELAINE JOSON PANTIG

Affiant

SUBSCRIBED AND SWORN to before me this ____________________, affiant

exhibited to me his/her Competent Evidence of Identity by way of his ID
__________________ issued at _____________________________ on __________________.

Doc. No. ________

Page No. _______
Book No.________
Series of 2018.