Republic of the Philippines)

Province of Cebu…………)S.S.

AFFIDAVIT OF UNEMPLOYMENT

I, __________________________, Filipino citizen, of legal age, widower and

resident of Cebu, after being duly sworn to in accordance with law and under pain of perjury
depose and state:

1. That I am the son of _________________________;

2. That I intend to file for correction of entry in the Certificate of Live Birth at
Municipal Civil Registrar’s Office, particularly the correction of entry with regards to
my FIRST NAME from _____________________;

3. That among the requirements for the petition of correction is Affidavit of

Unemployment;

4. That I am not presently employed with any company, firm, institution or any private
individual;

5. That I execute this Affidavit of Unemployment to attest to the veracity of the

foregoing facts as stated herein and for legal purposes and intents.

IN WITNESS WHEREOF, I have hereunto set my signature this

_________________ in _________________________, Philippines.

_____________________
Affiant
SSS ID No.:

SUBSCRIBED AND SWORN TO BEFORE ME, this _____________________ at

_________________________, Philippines, affiant personally known to me to be the same
person who executed the foregoing affidavit.

Doc. No. _____

Page No. _____

Book No. _____

Series of _____