Sample Affidavit Of Discrepancy.docx

REPUBLIC OF THE PHILIPPINES) QUEZON CITY ) S.S. AFFIDAVIT OF DISCREPANCY KNOW ALL MEN BY THESE PRESENTS: I, ____________________, of legal age, Filipino, married and resident of _______________, after having been sworn in accordance with law, depose and state: 1. That my name is _____________ as stated in my Passport No. ______________ issued on _____________ by the DFA NCR East; A copy of my Passport is hereto attached as “Annex A” 2. That the name __________ appears on Ticket No. ___________ issued by Cebu Pacific bound to Tokyo, Japan; A copy of the Cebu Pacific Ticket is hereto attached as “Annex B” 3. That on May 9, 2018, right after arriving at the airport I had the employee of TIEZA check my ticket and informed me that I haven’t paid the corresponding taxes; 4. That on May 9, 2018, while I was checking in my luggage, the person in the check-in counter informed me that I have already paid my travel taxes when I availed of my ticket and proceeded to provide me a document of proof that I have already paid the due taxes; 5. That on May 13, 2018, when I get back from Japan, I have filed a claim for Travel Tax Refund due to the error committed by the employees of TIEZA; A copy of the Travel Tax Refund is hereto attached as “Annex C” 6. That the names _____________ and ____________ refer to one and the same person; 7. That I am executing this affidavit to attest to the truth of the foregoing facts and to use the same for whatever legal purposes it may serve. IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of June 2018 at __________________________.

____________________________ Affiant

SUBSCRIBED AND SWORN to before me, this ____ day of June 2018 in ______________ City, Philippines, affiant exhibited to me her Passport No. _________ valid until ________________ and Driver’s License No. ________________ valid until October 05, 2021.

Doc No. ____; Page No. ___; Book No. ___; Series of 2018.