Affidavit of Discrepancy in Name
AFFIDAVIT OF DISCREPANCY
I, (Name, Citizenship, of legal age, Civil status), and with residence and postal address at ______________________________ after having been duly sworn to in accordance with law, do hereby depose and state:
1. That I am the child out of wedlock of (Name of father) and (Name of Mother who are native of ___________________________;
3. That since my parents were not legally married and the fact that they have already been separated since my infant age, I used the last name of my mother (Lastname) used in my school records and other transactions I entered. Copies of my School Transcript of Records and Diploma and other pertinent documents are hereto attached as Annex hereof;
4. That I discovered, however, in my Certificate of Live Birth, my full name is (the name used) instead of (the name supposed to be used). Machine copies of the said Certificate of Live Birth is hereto attached as Annex hereof;
5. In order to avoid confusion, I now categorically state under oath that the names (complete name) as appearing in my school records and complete name) as appearing in my certificate of live birth pertain to one and the same person;
6. 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 set my hand this ___ day of _____ 2005 in _______________
(Current Name Used)
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of ______ 2005 in _____________by Affiant, exhibiting to me her CTC number ________________ issued on _____________at ________ _____________.
Doc. No. ___________:
Page No. ___________:
Series of: __________:
Notary Public
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