REPUBLIC OF THE PHILIPPINES )
City of __________________ ) S.S.
AFFIDAVIT OF RECONCILIATION OF BIRTH DATA
I, (NAME OF AFFIANT), of legal age, single/married, and residing at __________________, after having been duly sworn to according to law, hereby depose and state – THAT:
1. I was born to Spouses __________________ and __________________ of __________________ on __________________;
2. In the birth certificate which I obtained only recently, my family name is spelled as “_______________” instead of “_______________” to which I have been used to as indicated in my school records, SSS, BIR and other public documents. A copy of said birth certificate which indicated my family name as “_______________” is hereto attached for reference;
3. The names _______________ and _______________ belong to one and the same person, the undersigned herein;
4. I am executing this affidavit in order to attest to the truth of the foregoing circumstances and for purposes of setting the records straight, and declaring that _______________ and _______________ refer to one and the same person.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date of Signing) in (Place of Signing), Philippines.
(NAME OF AFFIANT)
Affiant
SUBSCRIBED AND SWORN to before me, this (Date of Notarization) at (Place of Notarization) by (Name of Affiant) who exhibited to me his/her (ID Details).
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of _____.
