Republic of the Philippines

Province of Cavite
City of Trece Martires

)
) S.S
)

AFFIDAVIT CORRECTION
I, EUSEBIA PANUNCIAR BAYATO , of legal age, single, Filipino citizen, and
resident of 30 Salitran I, Dasmarinas , Cavite, after having sworn to in accordance with law,
hereby depose and state :
1. That I am presently causing application to obtain a Tourist VISA at the Australian
Embassy in the Philippines;
2. Unfortunately, there is an existing discrepancy as to the veracity of surname;
3. Through the foregoing affidavit it is explained that the discrepancy originated
sometime in 1994 when I had common law relations with Milo G. Rivera;
4. Since then even without a valid marriage I had habitually and continuously
indicated my surname as RIVERA in all of my personal and legal records . The
usage of the surname Rivera was primarily resorted to for the purposes of
convenience moreover for our children who were born out of wedlock appear
as legitimate;
5. That despite my usage of the surname Rivera I attest to the fact that I am
single and had not contracted any marriage to anybody here or abroad. This
claim is corroborated by a Certificate of No Marriage (CENOMAR), issued
by the National Statistics Office, the same being reproduced and made an integral
part hereof;
6. In the absence of any marriage, I am legally entitled to bear the surname
Bayato, and my full name is to be correctively indicated as EUSEBIA
PANUNCIAR BAYATO ;
7. That the names EUSEBIA PANUNCIAR BAYATO and EUSEBIA BAYATO
RIVERA are but one and the same individual, significantly referring to the
undersigned;
8. That I am executing this affidavit to attest the truthfulness of the foregoing
declarations under penalties of perjury, in support of the cause herein specified
moreover to support all other legal intents.
IN WITNESS WHEREOF, I hereby affix my signature on this 18 th day of October
2013 at Trece Martires City, Cavite .
EUSEBIA PANUNCIAR BAYATO
Affiant
SUBSCRIBED AND SWORN to before me on this 18 th day of October 2013 at
Trece Martires City, Cavite, affiant exhibiting to me her Drivers License with I.d with
No. D18-06-007375 as competent proof of identity.
Doc. No.
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474
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ATTY. FE B. AONUEVO
NOTARY PUBLIC Until 31 December 2014
ROLL OF ATTORNEY No. 35746

IBP No. 902501 - 08-15-12 Imus Cavite/ PTR No.

3179872 -01-07-13 TMC Cavite

4TH

MCLE Exemption No. 000189