REPUBLIC OF THE PHILIPPINES)

______________ ) S.S.

AFFIDAVIT OF ONE AND THE SAME PERSON

I, _____________________________________________, of legal age, Filipino, with

residential address at ________________________________________, after having sworn
in accordance with law, do hereby depose and state that:

1. I have been known by the name ____________________________________

and have been accustomed to using the same in my personal and official records,
transactions, and communications, as shown by the following:

a. Philippine Passport No. _________________ issued by the Department of

Foreign Affairs on __________________, a copy which is attached hereto as
Annex “A”;

b. Certificate of Membership in the Philippine Bar issued by the Office of the

Bar Confidant of the Supreme Court of the Philippines on
___________________, a copy of which is attached hereto as Annex “B”;
and

c. Driver’s License No. _______________________ issued by Land

Transportation Office on _________________________, a copy of which is
attached hereto as Annex “C”.

2. My name was recorded as _______________________________ on my Birth

Certificate registered at the Local Civil Registry in _______________, a copy of
which as certified by the Philippine Statistics Authority is attached hereto as
Annex “D”.

3. Both the name _____________________________ and

________________________________________ refer to one and the same person,
the herein Affiant.

4. I am executing this affidavit to attest the truth of the foregoing and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of

________ 2019 at ________.

_________________________________
Affiant
 SUBSCRIBED AND SWORN, to before me this __ day of __________ 2019 at
_____________, affiant exhibiting to me his __________________________ issued on
_____________________ at _____________________.

Doc. No. ;
Page No. ;
Book No. ;
Series of 2019.