I, (NAME OF AFFIANT), Filipino, of legal age, married, with postal address at (Residential Address of Affiant), after having been sworn to in accordance with law, hereby depose and state – THAT:
1. I am the same person who executed the long form signature appearing on my (Description of Identification Card or Document) under the name (Name of Affiant), and who executed the short form signature appearing on some official documents including those appearing on (Description of Documents where the different signature appears).
2. Both long and short form signatures as they appear in said official documents are therefore executed by one and the same person, the undersigned affiant, as I used the long form and at other times used the short form when I signed official documents, exercised my employment and transact with offices or agencies.
3. I agree to indemnify and hold (Name of Agency or Institution) and their respective officers, employees, and agents harmless from and against any liability incurred by said agency/institution for relying in good faith upon the declaration provided in this affidavit.
4. I am executing this affidavit to attest to the truth of the foregoing facts and to explain the difference in my signatures.
IN WITNESS WHEREOF, I have hereunto affixed my signature this _______________________, in the City of (Name of City).
(NAME OF AFFIANT) AffiantSUBSCRIBED AND SWORN to before me this ____________________ in (Name of City), with affiant exhibiting to me his (ID Details).
Doc. No. ____; Page No. ____; Book No. ____; Series of 2017. Posted by barops at 10:18 AM
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