Affidavit of Discrepancy of Surname

CITY OF MAKATI            ) S.S.


 I, SAM L. MILBY, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I was born on 15th day of the October 1960 to spouses Anna Lerma and John Milby;

2. I have been using the name SAM L. MILBY  in all my documents and transactions;

3. However, when I obtained a copy of my birth certificate, I discovered that my surname appearing thereon was erroneously written as "MELBY";

4. The names “SAM L. MILBY” and “SAM L. MELBY” refers to one and the same person;

5. I execute this Affidavit of Discrepancy of Surname to attest to the truth of the foregoing facts and to explain the discrepancy in my birth certificate with regards my surname.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Makati City, Metro ManilaPhilippines.

SSS ID No. _____________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________Philippines, affiant exhibiting to me his/her competent evidence of identity by way of __________________ issued at ______________ on __________________.

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


3 Comment

  • Unknown October 28, 2013 at 6:21 AM
    Hi good morning. I want to know if affidavit of dicrepancy will be accepted when i get a passport? Kasi yung surname ko is REQUIBO and all my family and sa documents ko yun po talaga ang right spelling . Nung kumuha po ako sa NSO ng birth certificate ko nakalagay is REQUEBO which is wrong. I want to hear from you about my concern .thank you
    • Inur September 18, 2019 at 1:52 PM
      I actually have the same problem pero sakin ung “~” lang sa taas ng middlename ko ung kulang..and I want to know if I can also use this affidavit to acquire passport
  • Unknown January 29, 2020 at 10:06 AM
    Ask ko lang po kung ung affidavit of discrepancy pwde po b gamitin kumuha ng student permit sa LTO?