REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF SAN JOSE DE BUENAVISTA) S.S.

AFFIDAVIT

I, ATTY. LV JO T. ESCARTIN, Filipino, of legal age, single, and a resident of Taft St., San Pedro, San Jose,
Antique, after having been duly sworn in accordance with law, hereby depose and say:

1. That KEITH VAGILIDAD with a sex of male and female in her Certificate of Live Birth is a female
as I have personally seen her.

2. That I executed this Affidavit for the purpose of attesting to the truth of all the foregoing
statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 12th day of September, 2017 in San
Jose, Antique, Philippines.
ATTY. LV JO T. ESCARTIN
AFFIANT

SUBCRIBED AND SWORN TO before me this 12th day of September, 2017 in San Jose, Antique, Philippines,
affiant being personally known to me with Attorney Roll Number 67817 as competent proof of her
identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2017.