REPUBLIC OF THE PHILIPPINES )

CITY OF BATANGAS ) S.S.

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AFFIDAVIT

I, VALIANT M. AGUILERA, of legal age, single, Filipino, and

presently residing at 1-A, Lot 13, Saint Vincent Subdivision Extension,
Brgy. Banay-Banay, Lipa, Batangas, after having been duly sworn to in
accordance with law hereby depose and state:

That on 05 November 2020, I requested for a COVID-19 RT PCR Test

from the Philippine Red Cross;

That in the Health Care Delivery Laboratory Result Form for the said
COVID-19 RT-PCR Test, my middle name was erroneously entered
thereon as MALAWAN instead of MALALUAN which is my true and
correct middle name as evidenced by my Driver’s License hereto attached
as Annex “A”;

That VALIANT AGUILERA y MALAWAN and VALIANT

AGUILERA y MALALUAN refer to one and the same person;

That I am executing this affidavit to attest to the truth of all the

foregoing facts and circumstances, and for whatever legal purpose this
may serve.

IN VIEW THEREOF, I have hereunto set my hand this 16th day of

November 2020 in Batangas City.

VALIANT M. AGUILERA
Affiant

SUBSCRIBED AND SWORN to before me this 16th day of

November 2020 in Batangas City.