REPUBLIC OF THE PHILIPPINES )

) S.S

AFFIDAVIT OF ONE AND THE SAME PERSON

I, ______________________________________________________ [Affiant], Filipino, of legal age, and a

resident of
_____________________________________________________________________________________
___________________________________________________________ [Address of Affiant] state under
oath that:

1. I personally know _____________________________________[Name of Person] for a period of

_____years as his/her _________________________________________________[relationship];

2. I also know for a fact that the above person and the person by the name of
“____________________________________”[Other Name of the Same Person] as appearing in
the attached identification documents, refer to one and the same person;

3. As such, I execute this Affidavit to attest to the truth of the above statement and for whatever
lawful purpose it may serve.

I have affixed my signature this _____ day of ____________ 2015 at ____________, Philippines.

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of _____________ 2015, in __________ personally
appeared [Affiant] exhibiting to me his/her Passport No. __________ issued on __________, as his/her
competent evidence of identity bearing his/her photograph and signature.

NOTARY PUBLIC

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of ____.