REPUBLIC OF THE PHILIPPINES )

MUNICIPALITY OF MADRIDEJOS ) S.S.

AFFIDAVIT OF NON-EMPLOYMENT

I, JENELOU PASTITEO PLACENSIA, of legal age, single, Filipino, and a resident of

Purok Bakhaw, Kodia, Madridejos, Cebu, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state THAT:

1. That as of the present time, I am not employed in any capacity at any

corporation, company, and sole proprietorship;
2. That I have applied for the Correction of Entry in my Birth Certificate,
specifically, of Sex/Gender in the Local Civil Registrar Office of
Madridejos, Cebu;
3. That this affidavit is executed to attest to the truth of the correction of entry
in my Certificate of Live Birth and for whatever legal purpose this may
serve;

Affiant further sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my signature this 17th of December, 2022
at Madridejos, Cebu, Philippines.

JENELOU PASTITEO PLACENSIA

Affiant
PHIL SYS I.D. NO. 5790-5302-4098-5489

SUBCRIBED AND SWORN TO before me this 17th of December, 2022 in Madridejos,

Cebu, Philippines, affiant exhibited to me his government issued ID as Competent Evidence of
Identity (CEI).

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.