Republic of the Philippines )

Done: In the City of Baguio ) S.S.

AFFIDAVIT OF DISCREPANCY
I, JOAN DUPLAAN SAMSON, of legal age, married, Filipino Citizen and
with residence and postal address at Dalupirip, Itogon, Benguet, after having
been duly sworn to in accordance with law hereby depose and state that:

1 I graduated at Benguet State University with the degree of Bachelor in

Elementary Education (BEE) and was issued an OFFICIAL
TRANSCRIPT OF RECORDS (OTR);

2 In my Official Transcript of Records my family name DUPLA-AN, it is

with a dash (-), however, comparing it with my Certificate of Live Birth
my family name has no dash, DUPLAAN. Hence, a discrepancy
appears as to my family name;

3 My correct family name is DUPLAAN, without a dash (-) as

evidenced by my Certificate of Live Birth and Professional
Identification Card (PRC License Card). The one who entered my name
in my Official Transcript of Record inadvertently written my family
name as DUPLA-AN, despite the fact that when I enrolled at the
said school I gave the correct details and information about my name;

4 The aforementioned discrepancy is explainable and attributable to

sheer oversight and/or honest mistake and is not tainted with any
deliberate malicious or criminal intent, but due only to
aforementioned circumstances. Thus, it is my intent to correct my
family name in my OTR from DUPLA-AN to DUPLAAN;

5 I am executing this affidavit to attest to the truth of my foregoing

statements and to support the correction of my Family Name in my
OTR and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 24th day of

April, 2017 at Baguio City, Philippines.

JOAN DUPLAAN SAMSON

Affiant
PRC Registration No. 0600290
Valid Until: 6-15-2018

SUBSCRIBED AND SWORN TO before me this 24th day of April, 2017 at

Baguio City, Philippines. Affiant personally appeared before me and hereby
certifies that she is the same person who executed this instrument freely and
willingly.
 MODESTO T. ANDONG
Notary Public
Commission No. 35-NC-16-R/Until: December 31, 2017
PTR No. 2945281/01-05-2017/Baguio City
IBP No. 1056844/01-05-2017/Baguio-Benguet Chapter
Roll No. 31289/5-15-81/Manila
Doc. No. 360; MCLE COMPLIANCE No. VI-0000192/June 14, 2016
Page No. 72; BIR TIN No. 121-017-652
Book No. XXII; No. 19, 2nd Floor Old Market Bldg.,
Series of 2017. Magsaysay Ave., Baguio City, Philippines