REPUBLIC OF THE PHILIPPINES )

CITY OF CALOOCAN )S.S.

AFFIDAVIT

I, GARY G. CABANGUNAY, of legal age, Filipino citizen, single with residence and postal
address at 146 5TH ST. BRGY. 7 SANGANDAAN CALOOCAN, after having been duly sworn to in
accordance with law, do hereby depose and say:

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 (BIRTH DATE) in my
Certificate of Live Birth before the Office of the Municipal Local Civil Registrar of Paranas,
Samar;

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;

AFFIANT FURTHER SAYETH NAUGHT.

Gary G. Cabangunay
Affiant
(Signature over Printed Name)

SUBSCRIBED AND SWORN to before me this _____day of ___________, in the year of our Lord
______ City of Caloocan, affiant having exhibited to me his/her __________________________ ID
bearing No. ___________________ issued by the _____________________ on __________________.

Doc. No. :_______________

Page No. :_______________
Book No. :_______________
Series of :_______________