REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) Sc.

MUNICIPALITY OF TUBAO )
x-------------------------x

AFFIDAVIT OF NO EMPLOYMENT
KNOW ALL MEN BY THESE PRESENTS:

I, SERWIN BERMISA RUNAYA, of legal age, single, Filipino citizen and a

resident of Leones East, Tubao, La Union, after having been duly sworn to in accordance with
law, do hereby depose and state,:

1. That I intend to file a petition to change my gender from FEMALE to MALE as

recorded in my Certificate of Live Birth to straighten my records as there is an
inconsistency with my recorded gender with my true and correct gender which should
be MALE;

2. That one of the requirements for said petition is record of employment with any
private or government agency;

3. That I am a student so that I have no work data record from any agency, private or
public;

4. I am executing this Affidavit to attest to the truthfulness and veracity of the foregoing
narration of facts and for whatever legal intents and purposes this may well serve.

IN WITNESS HEREOF, I have hereunto set my hand this 21 st day of April 2015 at
Tubao, La Union, Philippines.

SERWIN BERMISA RUNAYA

Affiant

SUBSCRIBED AND SWORN to before me this 21st day of April 2015 at Tubao, La
Union by the affiant appearing personally and who is known to me to be the same person who
executed this affidavit.

ATTY. JOONEE RANDYL E. RIVERA

Notary Public
Doc. No. 234; until December 31, 2016
Page No.: 47; Aspiras Highway, Francia Sur, Tubao, La
Union
Book No.: V; Roll No. 61766, TIN 929-347-628
Series of 2015. PTR No. 9680876; 01-06-15, Tubao, LU
IBP Lifetime OR No. 933274; 01-02-14, SFLU