REPUBLIC OF THE PHILIPPINES)

TAGUIG CITY ) S.S.

AFFIDAVIT OF DISCREPANCY IN NAME

I, ANA E. LOPEZ, of legal age, married, and with address at 2092 A. Cruz. Street
Lower Bicutan Taguig City, under oath, state:

1. THAT my name is Ana Cañada Evangelista as stated and registered in my birth

certificate issued by office of the Civil Registry of Buhi Camarines Sur. A copy of
my birth certificate is hereto attached as ANNEX “A”;
2. THAT since childhood, my friends and acquaintances call me “Anna Marie” and
thus since then I have been accustomed to using the name Anna Marie in my
personal records, transactions and communications;
3. THAT the name “Ana” E. Lopez and “Anna Marie” E. Lopez refer to one and the
same person, the herein Affiant;
4. THAT I am executing this Affidavit to attest to the truth of the foregoing facts
and to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this 26 t h day of April 2017 at

Taguig City.

Ana E. Lopez
Affiant

SUBSCRIBED AND SWORN to before me this 27 t h day of April 2017 Taguig City,
Affiant exhibiting to me her CTC No. _____________________

Doc No. _________

Page No. ________
Book No. ________