Discrepancy Surname

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REPUBLIC OF THE PHILIPPINES) S.S.

DONE: IN THE CITY OF BAGUIO)

AFFIDAVIT OF DISCREPANCY OF SURNAME

I, LINDSEY B. LOHAN, single, of legal age, Filipino


citizen and with residence and postal address at No. 8
Hillside, Baguio City, after having been duly sworn an oath in
accordance with law, hereby depose and say:

1. That on January 9, 2014, I was issued a Philippine


Passport with passport number 123456789 in which
my true surname LOHAN was stated;

2. That before the expiration of the aforementioned


passport on January 1; 2017, I had applied with
Philippine Embassy in Baguio City for the issuance of
a new passport and on December 28, 2016, I was
issued a new Philippine passport with passport no.
987654321;

3. That however, in the said new passport my surname


had been erroneously misspelled as LAHAN;

4. That I execute this Affidavit of Discrepancy to attest


to the truth of the foregoing facts and to explain the
discrepancy in my Philippine Passport with regards
my surname.

IN WITNESS WHEREOF, I have hereunto set my hand,


this 17th day of January, 2017 at City of Baguio, Benguet,
Philippines.

LINDSEY B. LOHAN
Affiant
SIGNED IN THE PRESENCE OF:

1. BRITNEY SPEARS 2. ORLANDO


BLOOM

SUBSCRIBED AND SWORN to before me this 17th day of


January, 2017 at City of Baguio, Benguet, Philippines affiant
exhibiting to me her Community Tax Certificate No.
123456788, issued at Baguio City on January 16, 2017.

Doc. No. 494


Page No. 99
Book No. XXIV
Series of 2017
ATTY. GINA K. PAKURAN
Notary Public for and in the City of Baguio
Until December 31, 2017
PTR No. 1234567/12-11-14/Baguio City
IBP No. 246810/12-11-14/Baguio City
GP Building, Session Rd., Baguio City

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