Republic of the Philippines) City of Manila ) s.s.

AFFIDAVIT OF LOSS

I, ROSO P. AUMAN, Filipino, married, of legal age, and resident of 32 Ubay St., Sta. Mesa Heights, Quezon City, Manila, under oath, depose and state that: 1. I was issued a Drivers License by the Land Transportation Office, with License No. G0696042351; a Social Security ID, with SS No. 33-9316888-9; a membership identification card from Puregold Q. I. Branch; a membership identification card from Shopwise Commonwealth Branch; and a membership identification card from Makro Cainta Branch. 2. On 20 December 2011, after getting off a tricycle along Sales Street, Sta. Cruz in Manila, I reached for my wallet from my belt-bag. There I noticed that said belt-bag was already slashed and said wallet was missing. Inside said wallet are my Drivers License, SSS Identification Card and other Membership cards. 3. I firmly believe that the above-stated Drivers License, SSS Identification Card and other Membership cards are nowhere to be found despite exercise of due diligence and that I firmly believe that the same are now beyond recovery. 4. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and to support the application for the issuance of a new copy of said Drivers License, SSS Identification Card and other Membership cards, in lieu of those which were lost. FURTHER AFFIANT SAYETH NAUGHT.

ROSO P. AUMAN Affiant

Subscribed and sworn to before me this 20th day of December, 2011 in the City of Manila, Affiant is personally known to me.

Registry No. ______________ Page No. _________________ Book No. _________________ Series of 2011.