Republic of the Philippines)

Province of Sorsogon )S.S.

Sorsogon City )

AFFIDAVIT

I, SENEN M. JANO filipino, of legal age, single, and a resident of Barangay

Salog, Sorsogon City, under oath hereby depose and state:

1. That my real name is SENEN MORADA JANO, I was born male on

November 19, 1980 of my parents AZUCENA MORADA JANO and
LEVI LABRADOR JANO;

2. That upon obtaining a copy of my birth certificate from the office of the
Philippine Statistics Authority (PSA) I noticed that a female gender was
entered in my record of birth;

3. That the male gender appeared in all my records both private and public
instrument except in my birth certificate;

4. That this affidavit is being executed to attest to the truth of the foregoing
statement and for whatever legal purpose this may serve;

SENEN M. JANO
Affiant
SSS Unified ID CRN-0033-7587341-9

SUBSCRIBED and SWORN to before me this _____ day of January 2020 at

Sorsogon City.

NOTARY PUBLIC

Doc. No. _____

Page No. _____
Book No. _____
Series of 2020