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Affidavit to Establish Single Identity of Names (Para sa iba ang pangalan sa NSO Birth Certificate at sa tunay na ginagamit.)
I, (Pangalan), (Pangalan), Filipino Filipino,, of legal legal age, with with postal postal address address at (Address), (Address), after after having having been sworn sworn to accordance with law, hereby depose and state:
1. That my name appearing in my Certificate of Live Birth issued by the National Statistics Offic (NSO) is (“Pangalan”) (“Pangalan”) , , as shown shown by a copy copy of the the said document document hereto hereto attached attached as Annex Annex “A”;
2. That however, I have been using the name (“Pangalan na laging ginagamit“), ginagamit“), a copy of the said documents using such name are hereto attached as Annexes “B” and “C”. (I-attach ang mga dokumentong nagpapatunay na dati mo pang ginagamit ang pangalan na iyan, driver’s license, SSS ID, school records, etc.)
3. That the names (“Pangalan (“Pangalan sa Birth Certificate” Certificate” ) and (“Pangalan (“Pangalan na ginagamit”) ginagamit”) refer to one a same person, person, which which is the the undersgined/aff undersgined/affiant iant herein; herein; 4. That I am executing this affidavit to attest to the truthfulness and veracity of the foregoing and whatever legal purpose it may serve best. IN WITNESS WITNESS WHEREO WHEREOF F, I have hereunt hereunto o affixed affixed my signatur signaturee this __th day of _______ _________ __ 20_ ________ _________City _City..
Republic of the Philippines) ) S.S.
SUBSCRIBED AND SWORN to before b efore me this ____ day of ___________ ___________ in _________City, _________City, wi affiant exhibiting to me his/her __________________. Doc. No. No. ____; ____; Page No. No. ____; ____; Book No. No. ____; ____; Series of 2009.