It might come as a surprise for some people when they discover that the name that they have been using is not the same with the name their birth certificates indicate. If that happens, some public and private offices often require that the person concerned issue an Affidavit of Discrepancy and additionally requiring two other disinterested persons to attest to the identity of the person who has discrepancy in his name.
In the example below, a certain JOHNNY DELA CRUZ later on discovers that his Birth Certificate indicates that his name is actually JUAN DELA CRUZ.
AFFIDAVIT OF DISCREPANCY
I, JUAN C. DELA CRUZ, of legal age, single, and a resident of Davao
City, after having been duly sworn to in accordance with law, hereby depose and
say:
That since I was young, I have been
using the name “JOHNNY C. DELA CRUZ;”
That I am
also known by my family and friends as “JOHNNY
C. DELA CRUZ”;
That recently,
I applied for membership with the Philippine Health Insurance Corporation
(PhilHealth) and as a requirement for such application, I was made to submit my
Birth Certificate;
That when
I requested for a copy of my Birth Certificate from the National Statistics
Office, I was surprised that my name as reflected on the official document is “JUAN C. DELA CRUZ” (A copy of the Birth Certificate is hereto appended as ANNEX “A” and
forms an integral part hereof);
That I
attest that “JOHNNY C. DELA CRUZ”
and “JUAN C. DELA CRUZ” is one and
the same person;
That from
now on, I will be using my true and correct name, JUAN C. DELA CRUZ.
That I am executing this affidavit
in order to attest to the truth of the facts aforementioned, and for any legal
purpose this may serve.
IN WITNESS WHEREOF, I have hereunto
set my hand this this _____________ at ____________.
JUAN C. DELA CRUZ
Affiant
Witnesses:
SUBSCRIBED AND SWORN to before me
this this _____________ at ____________,, affiant exhibiting to me his PhilHealth
ID No. ________________.
Doc
No. ___; Notary
Public
Page
No. ___;
Book
No. ___;
Series
of _____.
JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS
WE, WITNESS ONE and WITNESS TWO, both of legal age, both single, and
residents of Davao City, after having been duly sworn to in accordance with
law, hereby depose and say:
That we personally known “JOHNNY C. DELA CRUZ” because we are
family friends and we have known him for more than 30 years;
That we
also personally know that “JOHNNY C.
DELA CRUZ” has been using that name since he was a child;
That we
personally know that from available records, his authenticated Birth
Certificate indicates that his name is “JUAN
C. DELA CRUZ”;
That we
attest that “JOHNNY C. DELA CRUZ”
and “JUAN C. DELA CRUZ” is one and
the same person;
That we are executing this affidavit
in order to attest to the truth of the facts aforementioned, and for any legal
purpose this may serve.
IN WITNESS WHEREOF, I have hereunto
set my hand this this _____________ at ____________.
WITNESS ONE WITNESS
TWO
ID/CTC No. ID/CTC No.
Issued on Issued on
Issued at Issued at
SUBSCRIBED AND SWORN to before me
this _____________ at ____________, affiants exhibiting to me their competent
evidence of identity written below their names.
Doc
No. ___; Notary
Public
Page
No. ___;
Book
No. ___;
Series
of _____.
