Republic of the Philippine )

Province of Cavite ) S.S

Trece Martires City )

AFFIDAVIT OF NON-EMPLOYMENT

I, __________________, of legal age, married, Filipino citizen, and a resident of

_________________________, after having sworn to in accordance with law, hereby depose and
state:

1. That I am causing the processing of my Birth Certificate at the Local Civil Registrar of
____________ for the correction of my name;

2. That at a present I am not employed in any private or government office and

institution;

3. That I am executing this affidavit to attest of the foregoing facts under penalties of
perjury;

4. That I am further executing this affidavit as a compliance of the requirements needed

for the correction of my name, at the Local Civil Registrar of ____________, and for all
legal purpose and extent this may suit best.

IN WITNESS WHEREOF, I hereby affixed my signature on this ______ day of ______ at

Trece Martires City, Cavite.

_____________________
Affiant

SUBSCRIBED AND SWORN TO before me, a Notary Public in and for the City of Trece
Martires, this ______ day of ______, affiant _______________, whom I identified through the
following competent evidence of identity: _________________________ personally signed the
foregoing instrument before me and avowed under penalty of law to the whole truth of the
contents of said instrument.
.

Doc. No. : _________

Page No. : _________
Book No. : _________
Series of : 2021