REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ) SS.

AFFIDAVIT OF BIRTH

I, SASHA GREY, of legal age, married, Filipino, and

presently residing at Blk 55, Lot 66, Ibarra Homes,
Tulingan, Cavite, after having been duly sworn to in
accordance with law, do hereby depose and say:

1. I was born on February 15, 1990, in Aguy, Iloilo, to

spouses Marc Blazer and Nikki Benz;

2. This is supported by numerous authentic documents

attached in this affidavit; and I hereby certify that the
foregoing statements are correct.
3. I therefore have executed this Affidavit to attest the truth
I mentioned herein and for whatever legal purposes it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

th
30 day of January 2014 in Imus City, Cavite, Philippines.

SASHA GREY
Affiant
Philippine Passport No.
123456 valid until January 13,
2018
 th
SUBCRIBED AND SWORN TO before me this 30 day
of January 2014 in Imus City, Cavite, Philippines, affiant
exhibiting to me her competent evidence of identity
indicated below his above- stated name.

NOTARY PUBLIC

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