Republic of the Philippines}

City of Dumaguete S.S }

AFFIDAVIT OF UNEMPLOYMENT

I, JULIETO I. VILAN, of legal age, married to Ma. Riche F. Vilan, and a

resident of Junob (BABAJUBA), Dumaguete City, Negros Oriental, on oath hereby
depose and say that:

1. I have not been gainfully employed since June 2017 until present;

2. I execute this affidavit in compliance with the requirements for “Change of

Name” to be submitted to the Civil Registrar of Dumaguete City and for
any legal intents and purposes it may serve me best.

IN WITNESS WHEREOF, I hereby signed this Affidavit this ____ day 1of
January 2019 at Dumaguete City, Philippines.

JULIETO I. VILAN
Affiant
Driver’s License No. G02-16-003708
Expiring on 2021/06/30

SUBSCRIBED AND SWORN to before me this ____ day of January

2019, the affiant exhibiting his competent evidence of identify as above
indicated. Known to and to me known to be the person who executed the
foregoing instrument and he acknowledged to me that the same is his free act
and deed.

WITNESS MY HAND AND SEAL on the date first above-written.

Doc. No. ____.

Page No. ____.
Book No. ____.
Series of 2019.

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