Republic of the Philippines )

Province of Isabela )S.S.

Municipality of Cabagan )
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AFFIDAVIT
(of Unemployment)

I, NORIEL G. FERNANDEZ, of legal age, married, Filipino and resident

of San Isidro West, Sta. Maria, Isabela, after having been duly sworn to in
accordance with law, hereby depose and say that:

1. I am the same the same person executing this affidavit;

2. That I am applying for the Correction of my name in my Certificate of

Live Birth at the Local Civil Registrar of Sta. Maria, Isabela;

3. I am unemployed and belongs to the indigent families in our barangay;

4. I am executing this Affidavit to attest the veracity of the foregoing

statements and for the purpose of filing a petition for the correction of
my certificate of live birth.

IN WITNESS WHEREOF, I have set my hand 7th day of March 2019 at

Cabagan, Isabela.

NORIEL G. FERNANDEZ
Affiant

SUBSCRIBED AND SWORN to before me this 7th day of March 2019at

Cabagan, Isabela.

JHOEY C. BUENO
Public Attorney
(Pursuant to R.A. 9406)