AFFIDAVIT OF ONE AND THE SAME PERSON

I, CHRICIEL R. DELA CRUZ, of legal age, Filipino, married with postal

address at _________________________________________________ after having
been duly sworn to in accordance with law hereby depose and say that:
1. The Certificate of Live Birth with local civil registry no. ____ issued by
National Statistics Office (now Philippine Statistics Authority) indicates
my maiden name as DE CHAVEZ ROSEL;
2. On the other hand, in my Philippine Passport No. _____ issued on 15
October 2015, the name is indicated as ROSEL DELA CRUZ;
3. Both names pertain to one and the same person;
4. On 19 January 2013, I was married to Mark Anthony G. Dela Cruz as
evidenced by our Certificate of Marriage with Registry No. ____;
5. In accordance with Philippine laws, I am required to use the surname of
my husband DELA CRUZ as my surname;
6. I am executing this affidavit to attest to the truth and for whatever
legal purposes it may serve.
IN WITNESS WHEREOF, I hereby affix my signature this ___________________
at ____________.

R. DELA CRUZ
Affiant
SUBSCRIBED AND SWORN to before me this _____ day of _________2016.
Affiant exhibited to me her Passport No.
Doc. No.
_____;
Page No.
_____;
Book No.
_____;
Series of 2016