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    Affidavit of One and The Same Person

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    Nam Legalis Justitia Bellator
    Jimmy A. Paalisbo Jr. submitted documents to the Social Security System for a sickness benefit claim but his name was recorded without the suffix "Jr.". He affirms in this affidavit that "Jimmy A. Paalisbo" in the medical records and "Jimmy A. Paalisbo, Jr." in his Social Security System records refer to the same person, himself. He executes this affidavit to attest that the names refer to one and the same person, the affiant.

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    Affidavit of One and The Same Person

    Uploaded by

    Nam Legalis Justitia Bellator
    239 views1 page
    Jimmy A. Paalisbo Jr. submitted documents to the Social Security System for a sickness benefit claim but his name was recorded without the suffix "Jr.". He affirms in this affidavit that "Jimmy A. Paalisbo" in the medical records and "Jimmy A. Paalisbo, Jr." in his Social Security System records refer to the same person, himself. He executes this affidavit to attest that the names refer to one and the same person, the affiant.

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    Original Title

    AFFIDAVIT OF ONE AND THE SAME PERSON

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    Jimmy A. Paalisbo Jr. submitted documents to the Social Security System for a sickness benefit claim but his name was recorded without the suffix "Jr.". He affirms in this affidavit that "Jimmy A. Paalisbo" in the medical records and "Jimmy A. Paalisbo, Jr." in his Social Security System records refer to the same person, himself. He executes this affidavit to attest that the names refer to one and the same person, the affiant.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    239 views1 page

    Affidavit of One and The Same Person

    Uploaded by

    Nam Legalis Justitia Bellator
    Jimmy A. Paalisbo Jr. submitted documents to the Social Security System for a sickness benefit claim but his name was recorded without the suffix "Jr.". He affirms in this affidavit that "Jimmy A. Paalisbo" in the medical records and "Jimmy A. Paalisbo, Jr." in his Social Security System records refer to the same person, himself. He executes this affidavit to attest that the names refer to one and the same person, the affiant.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    REPUBLIC OF THE PHILIPPINES }

    OROQUIETA CITY } S.S.

    AFFIDAVIT OF ONE AND THE SAME PERSON

    I, JIMMY A. PAALISBO, JR., of legal age, Filipino, married, and residing at Purok 1, Tipolo,
    Plaridel, Misamis Occidental, on oath, depose and state:

    1. That I am a bonafide member of the Social Security System with SS Number 0819287357 and
    I am likewise employed with Paglaum Multi-Purpose Cooperative;

    2. That I am fully known by the name “Jimmy A. Paalisbo, Jr.”, and as recorded and registered
    before the Social Security System evidenced by my UMID E-Card;

    3. That I submitted the following documents: (a) Hematology; and (b) Chest X-Ray PA View to
    the Social Security System in support of my sickness benefit claim, but, unfortunately the same recorded
    the name “Jimmy A. Paalisbo” without the suffix “Jr.”;

    4. That “Jimmy A. Paalisbo, Jr.” in the Social Security System’s records and “Jimmy A.
    Paalisbo” in the Hematology and Chest X-Ray reports refer to one and the same person, the affiant.

    5. That I am executing this Affidavit to attest the truthfulness of the foregoing representation and
    for whatever legal purpose and intent it may serve best.

    IN WITNESS WHEREOF, I have hereunto signed this 22nd day of May, 2019 at Oroquieta
    City, Philippines.

    JIMMY A. PAALISBO, JR.


    Affiant
    UMID E-Card CRN 0111-4510725-2

    SUBSCRIBED AND SWORN TO BEFORE ME, on the date and place first above-written.

    Doc. No._____;
    Page No._____;
    Book No._____;
    Series of 2019

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