REPUBLIC OF THE PHILIPPINES)

___________________, BULACAN) S.S.

AFFIDAVIT OF ONE AND THE SAME PERSON

AND CORRECT NAME EXPLANATION

I, RONALDO SANTOS SANTOS, of legal age, Filipino and a resident of Sta. Elena,
Hagonoy, Bulacan, under oath hereby declare:

1) That I have been using the name RONALDO SANTOS SANTOS since childhood as
shown in my Certificate of Baptism dated October 29, 1966;

2) That I have been using the said name in all my personal and official transactions;

3) That when I secured a copy of my Certificate of Live Birth using the name Rolando
Santos Santos before the National Statistics Office (NSO), I found out that the name
ALFREDO appears in my record of my birth instead of RONALDO;

4) That in order to have the name corrected, I filed a PETITION FOR A CHANGE OF
NAME from ALFREDO to RONALDO before the Local Civil Registry Office of
Bulacan;

5) That the names ALFREDO SANTOS SANTOS and RONALDO SANTOS SANTOS,
are one and the same person as evidenced by a PETITION FOR A CHANGE OF
NAME which was granted and attained finality on January 8, 2014 as per Certificate
of Finality issued by Municipal Civil Registry of Hagonoy, Bulacan and affirmed by
Civil Registrar General on January 6, 2015;

6) That I am executing this Affidavit to attest to the truth of the foregoing facts and to explain
the correct name in my record of birth.

Affiant further sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of November,
2016, at _________________, Bulacan.

RONALDO SANTOS SANTOS

Affiant
ID NO. ______________

SUBSCRIBED AND SWORN to before me this ______ day of November, 2016, at

____________________, Bulacan, affiant exhibited to me his ID as indicated above.

NOTARY PUBLIC

DOC. NO. ____

PAGE NO. ___
BOOK NO. ___
Series of 2016