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AFFIDAVIT OF LOSS I, Janeth A. Magalso, of legal age, single, Filipino and residing Sitio Lupa, Highway Maguikay, Mandaue City, after being sworn to in a ordan e with law, depose and say that! ". I was pre#iously issued an A$%& Identifi ation Card'
(. I used to keep the abo#e)*entioned Identifi ation Card and other i*portant do u*ents in *y wallet' +. ,. find it' -. .he said e#iden e of identity is now beyond re o#ery' and A few days ago, I left the said e#iden e of identity in the ounter' I tried all efforts to lo ate the *ispla ed Identifi ation Card but I was not able to
/. I a* e0e uting this sworn state*ent, as re1uired, to enable *e to obtain a repla e*ent for that lost ard. I& 2I.&3SS 2H343%F, I ha#e hereunto set *y hand this 555 day of 5555555555, (6"+, in the City of 555555555555, 7hilippines.
JA&3.H A. MA8ALS% Affiant JURAT S9:SC4I:3; and S2%4& to before *e, this 555 day of 5555555555, in the City of Cebu o*plainant showing to *e his 555555555555555555 with I; &u*ber 5555555555 issued at 555555555555555555 on 555555555 as his o*petent e#iden e of identity.
NOTARY PUBLIC
;o . &o. 555' 7age &o. 555' :ook &o. 555' Series of (6"+.
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