Republic of the Philippines]

Santa Cruz, Laguna ] s.s.

AFFIDAVIT OF DISCREPANCY
AND CORRECTION OF DATA

I, ZALYNA MARQUEZ ROMANO, of legal age, Filipino, married and

resident of 05-174 Sito Masipag T.G. Cruz Subdivision, Brgy. Duhat, Sta.
Cruz, Laguna after having been sworn in accordance with law, hereby
depose and state that –

1. I am the owner of an expired Philippine Passport No. XX4281351. In

the said passport, my birth place appeared as San Pablo City. That
was a mistake which originated from a wrong entry in the
preparation of my application for passport. My correct birth place is
in Tiaong, Quezon which appears in my Certificate of Live Birth
issued by the National Statistics Office (NSO) and attached to this
affidavit.

2. The mistake was due the fact that in the past, presentation of a birth
certificate was not a strict requirement in applying for a passport.
Hence, the error was committed in the old application for passport.

3. The person named ZALYNA MARQUEZ ROMANO in Philippine

Passport No. XX4281351 and the person named ZALYNA MARQUEZ
ROMANO in the attached Certificate of Live Birth refer to one and
the same person, the undersigned affiant.

IN WITNESS WHEREFORE, I hereto affixed my signature this 17

September 2016 in Santa Cruz, Laguna.

ZALYNA MARQUEZ ROMANO

Affiant

SUBSCRIBED AND SWORN to before me this 17th day of September

2016 by the affiant who exhibited to me her Philippine Passport No.
XX4281351 issued at DFA Lucena.

Doc. No. _____; A T T Y. E M M A N U E L E . S A N D I C H O

Page No._____; NOTARY PUBLIC, COMMISSION UNTIL 31 DEC. 2016
Book No._____; NOTARY PUBLIC FOR THE PROVINCE OF LAGUNA
Series of 2016. PER NOTARIAL COMMISSION SP. PROC. NO. 164(15)
IBP O.R. No. 995689, 04 January 2016, Laguna Chapter
PTR O.R. No. 2967138, 04 January 2016, Laguna
Roll No. 42246, admitted to practice law on 9 May 1997
MCLE Compliance No. V-0015412, dated 6 March 2016