REPUBLIC OF THE PHILIPPINES )

CITY OF MANDAUE
) S.c.
AFFIDAVIT OF LOSS
I, REBECCA A. ARNOZA, of legal age, married, Filipino and a
resident of Admacor, Maguikay, Mandaue City, Cebu, after being sworn to
in accordance with law, depose and say that:
1.

I was previously issued a company ID (Profoods International

2.
pocket;

I used to keep the above-mentioned evidence of identity in my

Inc.);

3.
A couple of days ago, while I was on my way to my home from
workplace, I accidentally left my ID;
4.
I tried all efforts to locate the misplaced evidence of identity but
I was not able to find it;
5.

The said ID is now beyond recovery; and

6.
I am executing this sworn statement, as required, to enable me
to obtain a replacement for the said lost proof of identity.
IN WITNESS WHEREOF, I have hereunto set my hand this 27 th day
of July 2015, in the City of Mandaue, Philippines.

REBECCA A. ARNOZA
Affiant
JURAT
SUBSCRIBED and sworn to before me, this 27th day of July 2015, in
the City of Mandaue by the above-mentioned affiant with the following
competent evidence of identity:
Evidence of Identity
CTN Manpower Services ID

ID Number
150626239

Validity Date
Up to Present

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2015.
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