Republic of the Philippines ] Santa Cruz, Laguna ] s.s.

AFFIDAVIT OF DISCREPANCY I, NENITA SANDICHO BERNARDINO, senior citizen, Filipino, widow and resident of Brgy. Palasan, Santa Cruz, Laguna 4009, after having been sworn in accordance with law, hereby depose and state that – 1. I am the holder of a Senior Citizen I.D. No. 821024 issued by the Office of Senior Citizens

Affairs, Santa Cruz, Laguna. In the said I.D., my name appears as NENITA SANDICHO since I am already a widow.

2. In some of my medical records, my name appears as NENITA BERNARDINO. The surname

“Bernardino” was taken from my deceased husband. As I am already a widow, I can already use my maiden surname “Sandicho”. Hence in other records, my name simply appears as NENITA SANDICHO.

3. I hereby certify and affirm that the names “NENITA SANDICHO”, “NENITA SANDICHO

BERNARDINO”, “NENITA S. BERNARDINO” and “NENITA BERNARDINO” refer to one and the same persons, the undersigned.

4. I executed this affidavit to attest to the truth of the foregoing facts and for whatever lawful

purposes this may serve.

IN WITNESS WHEREFORE, I hereto affixed my signature this 28th day of December 2009 in Santa Cruz, Laguna.

NENITA SANDICHO BERNARDINO Affiant SUBSCRIBED AND SWORN to before me by the affiant with Senior Citizen I.D. No. 821024

issued on 12 September 2000 in Santa Cruz, Laguna.

Atty. EMMANUEL E. SANDICHO NOTARY PUBLIC Comm. Until 31 December 2009

Doc. No. _____; PTR No. 7362174, 9 Jan. 2009, Laguna Page No._____; IBP No. 739042, 8 Jan. 2009, Manila-IV Book No._____; Roll No. 42246 admitted on 9 May 1997 Series of 2009