REPUBLIC OF THE PHILIPPINES)

CITY OF GENERAL SANTOS )S.S.

X--------------------------X

AFFIDAVIT OF DISCREPANCY

I, BITAGA OGIS PICO , Filipino, of legal age, widower and resident of

Kihan Malapatan, Sarangani Province after having been duly sworn to in
accordance with law, hereby depose and say:

1. That I am the same BITAGA OGIS PICO who was born on JULY
01, 1948 at Kihan Malapatan, Sarangani Province;

2. That however, in my SENIOR CITIZEN I.D, my first name was

erroneously entered as “BITOCA” instead of the correct one as
“BITAGA” as appearing in my PHILHEALTH record and other
pertinent documents;

3. That moreover, my middle initial was also erroneously entered

as “N”, instead of “O” as the correct one;

4. That the erroneous first name which is “BITOCA”, and incorrect

middle initial which is “N” must have been entered due to
mere inadvertence or clerical error;

5. That the names “BITAGA OGIS PICO” and “BITOCA N. PICO”

refers or belongs to me as one and the same person;

6. That such mistake was not done to defraud any institution but
for mere clerical errors and miscommunications which was
done inadvertently and can be easily corrected;

7. That I execute this affidavit to attest to the truth of the

foregoing for all-legal intents and purposes.

IN WITNESS WHEREOF, we have hereunto set my hand this

______________________ in General Santos City, Philippines.

BITAGA OGIS PICO

Affiant

SUBSCRIBED AND SWORN TO before me this ___________________ in

General Santos City, affiant exhibited his PH No. 230017244049.