Republic of the Philippines )

……………………………... ) S.S.

AFFIDAVIT TO PROVE GENDER

I, ____________________________, of legal age, married, Filipino, and a
resident of __________________________________________, UNDER OATH,
do hereby depose and state that:

01. I was born on _______________ at ______________________;

02. In _______, when I secured a certified true copy of my Certificate of Live

Birth from the Philippine Statistics Authority (PSA), I found out that the
entry for my Sex/Gender was inadvertently left blank; Copy of my
Certificate of Live Birth is hereto attached as ANNEX “A”;

03. I am executing this affidavit to prove that my gender is ___________ as

shown by my other supporting documents such as but not limited to my
Baptismal Certificate hereto attached as ANNEX “B”, my LTO Driver’s
License hereto attached as ANNEX “C”, and my Philippine Passport
hereto attached ANNEX “D”;

04. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purpose this may serve.

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

of __________ in _________________, Philippines.

________________________________
Affiant

SUBSCRIBED AND SWORN to before me on this ____ day of ____________

in ____________________________ Philippines. Affiant was identified through
his respective driver’s license photocopied below.

Doc. No. _______; NOTARY PUBLIC

Page No. _______;
Book No. ______;
Series of 2022.