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Republic of the Philippines) )s.s AFFIDAVIT RE: CHANGE OF CIVIL STATUS I, DIANNE KRISTINE C. GEORGE-MORENO , of legal age, married, Filipino and a resident of Unit 7F Molave Tower, Suntrust Parkview Natividad Lopez St., Ermita, Manila, after having been duly sworn in accordance with law do hereby depose and say: 1. That I am the same DIANNE KRISTINE C. GEORGE who is the affiant herein;
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  Republic of the Philippines))s.s AFFIDAVITRE: CHANGE OF CIVIL STATUS I, DIANNE KRISTINE C. GEORGE-MORENO , of legal age, married,Filipino and a resident of Unit 7F Molave Toer, !untrust Par vie #atividad$ope% !t., &rmita, Manila, after having been dul' sorn in accordance ith lado hereb' depose and sa'(.That I am the same DIANNE KRISTINE C. GEORGE ho is theaffiant herein*+.That m' civil status appearing in the m' records ith the !ocial!ecurit' !'stem !!!), -ome evelopment Mutual Fund Pag/Ibig),0ommission on &lection 0omelec) Philippine -ealth Insurance0ommission Phil-ealth) and Professional Regulation 0ommissionPR0) is SINGLE hereas, m' name appears as DIANNE KRISTINEC. GEORGE , m' maiden name*1.That I am no married, hence, m' civil status in m' records ith the!ocial !ecurit' !'stem !!!), -ome evelopment Mutual Fund Pag/Ibig), 0ommission on &lection 0omelec) Philippine -ealth Insurance0ommission Phil-ealth) and Professional Regulation 0ommissionPR0) should be changed from !I#2$& to M3RRI& and m' namefrom DIANNE KRISTINE C. GEORGE to DIANNE KRISTINE C.GEORGE-MORENO * 4.That this change of status and name as made ithout intent ofdefrauding nor evade obligation hich might result to fraud tocontracts*5.That I am e6ecuting this affidavit to attest to the truth of all theforegoing statements and for hatever legal purpose it ma' serve. IN WITNESS WHEREOF , I have hereunto set m' hand this  da' of  +89 at , Philippines.  DIANNE KRISTINE C. GEORGE- MORENO    Affiant SUBSCRIBED AND SWORN  to before me this  da' of  +89 at , Philippines.oc. #o.  Page #o. *:oo #o. * !eries of +89.
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