Sample Affidavit of Correction

CITY OF _________________ ) S.S.


          WE, ___________________ and _________________, both of legal age, Filipino citizens, married and residents of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. We personally know the person of  EARL PADUA ROXAS who was born on April 30, 1994 in Panabo, Davao del Norte, he being the legitimate son of  our close friend and neighbor, the  Spouses Rafael Roxas and Cher Padua (both deceased);

2. In the Certificate of  Live Birth of  EARL PADUA ROXAS  filed in the National Statistic Office his surname and the surname of  his father  were erroneously entered and spelled as “ ROJAS”  while his middle name and of  his mother were also erroneously entered as “LADUA”;

3. The true and correct spelling of  the  middle name and surname of  EARL PADUA ROXAS is  “PADUA” and "ROXAS", respectively;

4. The names  “EARL PADUA ROXAS” and “EARL LADUA ROJAS" refer to one and the same person;

5. We are executing this affidavit to attest to the foregoing facts. 

IN WITNESS WHEREOF, we have hereunto set our hands this ___________________ in _______________Philippines.

    SSS ID No. ___________

    GSIS ID No. ____________

   SUBCRIBED AND SWORN TO before me this ___________________ in _________________Philippines, affiants exhibiting to me their valid proofs of identification.

Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2013.