REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I, MARI LOUISE ALMONIA-ABELLANO, of legal age, Filipino, married and
resident of #304 St. Anne St., Perpetual Village, Pulanglupa, Las Pias City,
after having been duly sworn to in accordance with law, hereby depose and say
that:
1. I am a holder and owner of SSS identification card issued by the Social
Security System (SSS), in which, inter alia, contained the following personal
information:
BIRHTDATE
SEX
NATIONALITY
SSS I.D. No.
NAME

: July 24, 1989

: Female
: Filipino
: 34-2136116-3
: MARI LOUISE CASTOR ALMONIA

2. Said SSS identification card inadvertently got lost.

3. Despite of diligent efforts to look for said SSS identification card, all
such efforts proved futile and in vain, thus, I am declaring the loss of my said
SSS identification card.
4. In the said SSS I.D., my name appears therein as MARI LOUISE
CASTOR ALMONIA as a single person, however, upon my marriage to MARK M.
ABELLANO, in March 8, 2013, I started using the surname of my husband by
using the name of MARI LOUISE ALMONIA-ABELLANO
5. I have never lent or allowed any person to use my said SSS
identification card nor has such SSS id card been confiscated by law
enforcement agencies or the subject of any pending litigation.
6. I am executing this affidavit to attest to the truth of the foregoing facts
for all its legal intents, effects, consequences and purposes including to change
my name from: MARI LOUISE CASTOR ALMONIA as single person to MARI
LOUISE ALMONIA-ABELLANO as a married person in my SSS records, and for
the issuance to me of another SSS identification card in lieu of the one that was
lost.

MARI LOUISE ALMONIA-ABELLANO

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this July 28, 2014at Las
Pinas City.

Doc No. 204

Page No. 42
Book No. 85
Series of 2014.