You are on page 1of 1

Republic of the Philippines)

City of Legazpi
) s.s.
x-------------------------------------------x

AFFIDAVIT
I, LAWRENCE M. BUENAOBRA, of legal age, Filipino, single with residence and
postal address at Cristo Rey, Baao, Camarines Sur after having been duly sworn in
accordance with law, do hereby depose and state, that:
1. That I was born on October 18, 1990 at Cristo Rey, Baao, Camarines Sur
and a Certificate of Live Birth was registered with the Local Civil Registrar of Baao,
Camarines Sur.
2. That when I secured a NSO copy of my Certificate of Live Birth, I found
out that the entry for my Sex/Gender was erroneously indicated as Male when in
truth and in fact I am a Female.
3. I am executing this affidavit to attest to the truthfulness of the
foregoing declarations and for the purpose of solemnization of marriage and for
whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of
November, 2014 at Legazpi City, Philippines.

LAWRENCE M. BUENAOBRA
Affiant
SUBSCRIBED AND SWORN to before me this 10th day of November, 2014 at
Legazpi City, Philippines.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2014.

You might also like