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Birth Date

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Birth Date

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Republic of the Philippines}

Province of Bohol}
City of Tagbilaran} S.S.

AFFIDAVIT OF DISCREPANCY

I, SOFIA P. CADENAS, Filipino, of legal age, married, and a resident of Purok 6


Anthurium, Tabuan, Garcia Hernandez, Bohol, Philippines, after being duly sworn in accordance
with law, depose and state:

1. That my birth date appearing in my Certificate of Marriage is “September 29, 1969”;

2. That the person with birth date: (1) “September 29, 1969” appearing in my Certificate of
Marriage, and the person with birth date (2) “September 9, 1969” appearing in my
Certificate of Birth, refer to one and the same person and that my true and correct
date of birth is “September 9, 1969”;

3. That the birth date “September 29, 1969” as r eported in my Certificate of Marriage as
my birth date is merely caused by a typographical error;

4. That I am executing this Affidavit to attest to the truth of the foregoing facts, for the
correction of my birth date in my PRC License, to clear any discrepancy in my records
with the PRC and for whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, I set my hand this ___________________, in Tagbilaran


City, Bohol, Philippines.

SOFIA P. CADENAS
Affiant
PH I.D. No. 3421-4594-6197-5409

SUBSCRIBED AND SWORN to before me this _________________ in Tagbilaran


City, Bohol, Philippines.

Doc. No. ______

Page No. ______

Book No. ______

Series of 2024

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