Republic of the Philippines)

City of Cebu
)
x---------------------------------/
SUPPLEMENTAL AFFIDAVIT
I, MARJULET D. LABOS, of legal age, single, Filipino Citizen,
and a resident of 214-H V. Rama Avenue Cebu City after having
been sworn to in accordance with law hereby depose and states:
1. That I was born on July 13, 1990 and the fact of my birth
was recorded in the Local Civil Registrar of Cebu City on
August 13, 1990 under Local Civil Registry No. 90-988;
2. That in my Local Birth Certificate registered in the Office
of the City Civil Registrar in Cebu City, it contained all
information regarding the facts of my birth;
3. That however, in the birth certificate issued by the
Philippines Statistics Authority ( PSA ), I noticed that with
respect to the entry of my ( Sex )Gender, it did not
indicate whether I am a male or female;
4. That I execute this SUPPLEMENTAL AFFIDAVIT in order to
request the office of the Philippine Statistics Authority
( PSA) to supply the Entry of my Sex ( Gender) in said
birth certificate by indicating in the entry that I am a
female in order to conform their records of my birth
registered in their office with respect to the records of my
birth certificate registered in the Office of the Civil
Registrar Cebu City;
5. That further I execute this Affidavit in order to attest to
the truth of the foregoing facts and for what other purpose
that this affidavit may legally served.
In witness whereof, I have hereunto
this____________________in Cebu City Philippines.

set

my

hand

MARJULET D. LABOS
( AFFIANT )
SSS UNIFIED MULTIPURPOSE ID NO CRN-0111-4726494-4
Subscribed and sworn to before me this__________________in
Cebu City Philippines. Affiant showed to me her identification card
written below her name as competent proof of her identity.