Republic of the Philippines )

Municipality of Tudela ) S.S.

AFFIDAVIT OF NON EMPLOYMENT

I, WERT, 71 years old, Filipino citizen, married to WASD and a resident of

Barangay Maikay, Tudela, Misamis Occidental Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state THAT:

1. To this date, I am not employed in any capacity at any corporation,

company, individual person or with the government;

2. I am executing this Affidavit of Non-Employment to attest to the truth

of the foregoing and to support my application for Correction of Clerical
Error for R.A. 10172 (GENDER) in my Certificate of Live Birth before the
Office of the Municipal Local Civil Registrar of Tudela, Misamis Occidental;

3. I am executing this Affidavit to attest to the truth of the foregoing

statements and for whatever legal purposes and intents this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day

of ________________at _________________ Philippines.

WERT
Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicated

above. Affiant exhibited to me his Voter’s Registration ID bearing his 1234567890
issued by the Commission on Elections.