C I T Y OF _______________________)s.c.
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I, (insert name of affiant) , Filipino, of legal age, single/married to (insert name of spouse if any), and a resident of (insert address of affiant), and I (insert name of affiant) , Filipino, of legal age, single/married to (Insert Name of Spouse if any), and a resident of (insert address of affiant), after having been duly sworn in accordance with law, do hereby depose and say:
1. That we personally know ____________________________ who was born on __________________, at ___________________ to parents _________________ and _____________________;
2. That we likewise fully know that he/she was baptized according to the rites of (the Roman Catholic church/or whatever religious denomination) at __________________________;
or- That we likewise fully know that he/she is a bonafide member of the Social Security System with SS Number __________________; or- That he/she is a graduate of __________________;
3. That in his/her (Baptismal Certificate/SSS records/school records, etc.), certain errors appear such as _____________________________ which should be ____________________________;
4. That ___________________________ (erroneous entry) and ___________________________________ (correct entry) pertain to one and the same person who should be _______________________________ (correct entry);
5. That we are not in any way related to any of the foregoing persons within the fourth civil degree either by consanguinity or affinity, nor do we have any pecuniary interest in this matter whatsoever.
6. That we are executing this Affidavit to attest to the truthfulness of the foregoing statements and to establish the fact that ___________________________ (erroneous entry) and ___________________________________ (correct entry) pertain to one and the same person who should be _______________________________ (correct entry) and for whatever legal purpose this may serve best.
Further Affiant sayeth none.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ......... day of ..................... , 20__ in ..................................... Philippines.
_________________________________________ __________________________________________ (Signature of Affiant over Printed Name) (Signature of Affiant over Printed Name)
SUBSCRIBED AND SWORN before me this........ day of ........................... 20__, by ............................................. who exhibited to me his CTC No. ................................... issued on ................................. at ...........................................
Notary Public
Doc. No. .........:
Page No. .........;
Book No. .........;
Series of 20__.
