Affidavit of Loss (Bank)

REPUBLIC OF THE PHILIPPINES )
CITY OF MANILA) S.S.
AFFIDAVIT OF LOSS
I, NNYLEL EDRIAN GABRIEL SAGABAEN Filipino,
of legal age, single and with postal address at 743 -
Carino Paniqui Tarlac, after having been duly sworn to in
accordance with law, do hereby depose and say that:
1. I loaned an Apple Ipad 4 Wifi to MZE CELLULAR

PHONESHOP last June 25, 2014 and was issued a
corresponding receipt;
2. Such receipt was placed by me in my wallet along with

my cash and other cards and IDs;
3. On June 29, 2014 while I was looking for the said

receipt, I noticed that it was missing from my wallet;
4. Diligent efforts were exerted to recover the said Official

Receipt issued by the pawnshop, but they proved futile
as I was not able to recover the same;
5. I now consider the said MZE CELLULAR PHONESHOP

OFFICIAL RECEIPT as lost and I am executing this
affidavit for whatever other legal purpose it may serve;
6. I am executing this Affidavit to attest the truthfulness of

all the foregoing facts.
IN WITNESS WHEREOF, I have hereunto affixed my

signature this 1st of July, 2014 in the City of Manila.
NNYLEL EDRIAN GABRIEL

SAGABAEN
Affiant
SUBSCRIBED AND SWORN to before me this 1st of

July, 2014 in the City of Manila after affiant exhibiting to me
his Drivers License with ID No. C-11-13-004791
Doc. No. 338;
Page No. 69;
Book No. 18;
Series of 2014.

AFFIDAVIT OF LOSS
I, DEBORA L. UY Filipino, of legal age, married and
with postal address at No. 1128-B Ma. Christina Street,
Sampaloc Manila, after having been duly sworn to in
7. I am bank customer of PNB Marulas Valenzuela as

such I was issued PNB ATM Card for my Saving
Account with ATM NO. 5921-0850-3905-1070;
8. I am in possession of the said PNB ATM Card;
9. Sometime in June 2014, I discovered that I could no

longer find the above-mentioned PNB ATM Card;
10. Diligent efforts were exerted to recover the said

PNB ATM Card, but they proved futile as I was not able
to recover the same;
11. I now consider the said PNB ATM Card as stolen

and lost and I am executing this affidavit for whatever
other legal purpose it may serve;
12. I am executing this Affidavit to attest the

truthfulness of all the foregoing facts.

signature this July 1, 2014 in the City of Manila.
DEBORA L. UY
Affiant
SUBSCRIBED AND SWORN to before me this July 1,

2014 in the City of Manila after affiant exhibiting to me her
UST Employment Identification Card with ID NO. 3675.
Doc. No. 336;

Page No. 69;
Book No. 18;
Series of 2014.

AFFIDAVIT OF LOSS
I, KEVIN PATRICK BOLO Filipino, of legal age,
single and residence of Block 2 Lot 7 Rafaela 1 compound
Ampid 1 San Mateo Rizal after having been duly sworn to
in accordance with law, do hereby depose and say that:
13. I was a student of the University of Santo Tomas

with Electrical Engineering as my major;
14. As such I was issued a UST ID with student

number 2009009155;
15. Sometime 2010, I went to an agency Top Spot

along Rodriguez Highway where I was made to
surrender my ID, after which I realized that my ID was
no longer with me;
16. Diligent efforts were exerted to recover the said

UST ID, but they proved futile as I was not able to
recover my ID from the agency;
17. I now consider my UST ID as lost and I am

executing this affidavit for whatever other legal
purpose it may serve;

signature this June 3, 2014 in the City of Manila.
KEVIN PATRICK BOLO

Affiant
SUBSCRIBED AND SWORN to before me this June 3,

2014 in the City of Manila after affiant exhibiting to me his
Unified Multi-Purpose ID with No. CRN-0111-1843296-7
Doc. No. 209;

Page No. 43;
Book No. 18;
Series of 2014.

AFFIDAVIT OF LOSS
I, LEONCIA N. OLONAN Filipino, of legal age,
married and residence of 18 Road 11 Project 8 Quezon
City after having been duly sworn to in accordance with
law, do hereby depose and say that:
19. I was given the Social Security No. 03-6707156-5

and with that I applied for an SSS ID;
20. Such ID was placed by me in my wallet, along

with my other personal Identification Cards and cash;
21. Around May 2014, as I was looking for my SSS

ID , I can no longer find the same in my wallet, my bag
and all other places where I could have placed the
same;
22. Diligent efforts were exerted to recover the same,

but they proved futile as I was not able to recover the
said SSS ID;
23. I now consider such SSS ID as lost and I am

purpose it may serve;


signature this May 13, 2014 in the City of Manila.
LEONCIA N. OLONAN
Affiant
SUBSCRIBED AND SWORN to before me this May 13,

University of Santo Tomas Hospital Medical Staff ID.
Doc. No. 31;

Page No. 8;
Book No. 18;
Series of 2014.

AFFIDAVIT OF LOSS
I, FREDERICK AGARAO FERNANDEZ Filipino, of
legal age, married and residence of 1740 Kalimbas Street,
Santa Cruz, Manila City after having been duly sworn to
in accordance with law, do hereby depose and say that:
25. I am a depositor of China Bank Corporation with
Saving Account No. 245-017094-4;
26. As such I was issued by the above-stated bank an

ATM Card;
27. On April 2014 the said China Bank Corporation

ATM Card was lost;
28. Diligent efforts were exerted to recover the same,

but they proved futile as I was not able to recover the
said China Bank Corporation ATM Card;
29. I now consider such China Bank Corporation ATM

Card as lost and I am executing this affidavit for
whatever other legal purpose it may serve;


signature this April 28, 2014 in the City of Manila.
FREDERICK AGARAO
FERNANDEZ
Affiant
SUBSCRIBED AND SWORN to before me this April 28,

PRC License (Physician) License No. 0114128 issued on
09/04/2008 valid until 12/08/2014.
Doc. No. 484;

Page No. 98;
Book No. 17;
Series of 2014.
AFFIDAVIT OF LOSS
I, CAMILA SIENNE H. LIM, Filipino, of legal age,
single and with postal address at B5 L16 Adrano St. Ph3
Roma De Citta Italia Bacoor, Cavite after having been duly
sworn to in accordance with law, do hereby depose and
say that:
31. At around 12:30p.m. on March 11, 2014, while I

was walking around Dapitan St. Sampaloc, Manila, my
wallet was taken from my bag.
32. That said wallet contained all my cards including

my FIREARMS LICENSE and other personal effects.
33. Diligent efforts were exerted to recover the same;

however they proved futile as I was not able to know
who the one who took my wallet was.
34. I now consider such wallet with my Firearms

license as lost and I am executing this affidavit for
whatever other legal purpose it may serve.


signature this March 11, 2014 in City of Manila.
CAMILA SIENNE H. LIM

Affiant
SUBSCRIBED AND SWORN to before me this March

11, 2014 in City of Manila after affiant exhibiting to me his
UST ID No. 2011029612
Doc. No. 331;
Page No. 68;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, CAMILA SIENNE H. LIM, Filipino, of legal age,
single and with postal address at B5 L16 Adrano St. Ph3
Roma De Citta Italia Bacoor, Cavite after having been duly
sworn to in accordance with law, do hereby depose and
say that:
36. At around 12:30p.m. on March 11, 2014, while I

was walking around Dapitan St. Sampaloc, Manila, my
wallet was taken from my bag.
37. That said wallet contained all my cards including

my DRIVERS LICENSE and other personal effects.

however they proved futile as I was not able to know
who the one who took my wallet was.
39. I now consider such wallet with my Drivers

License as lost and I am executing this affidavit for
whatever other legal purpose it may serve.


signature this March 11, 2014 in City of Manila.
CAMILA SIENNE H. LIM
Affiant
SUBSCRIBED AND SWORN to before me this March

UST ID No. 2011029612
Doc. No. 330;

Page No. 67;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, GERARD K. LINSANGAN, Filipino, of legal age,
single and with postal address at 1212 Cristobal St.
Sampaloc, Manila, after having been duly sworn to in
41. I am a graduate of Lourdes School of Quezon City

in year 2000 and as such I am issued my high school
diploma.
42. Sometime September 2009, Typhoon Ondoy

Struck our city and our house was flooded and among
those destroyed was my high school diploma.

however they proved futile as the same was totally
destroyed by the flood.
44. I now consider such diploma as lost and I am

purpose it may serve.

signature this February 27, 2014 in City of Manila.
GERARD K. LINSANGAN
Affiant
SUBSCRIBED AND SWORN to before me this February

PRC ID No. 0362321
Doc. No. 297;

Page No. 61;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, MARIA KATREENA M. ESLAVA, Filipino, of legal
age, single and with postal address at Unit 809 Galleria
Suites Padre Noval St. Sampaloc, Manila, after having
been duly sworn to in accordance with law, do hereby
depose and say that:
46. I am the owner of an Intellicare Card (Health

Card).
47. That Sometime November 2013, while I was

walking along Eloisa St. Laong-Laan, Sampaloc, Manila,
a guy came from behind me and took snatched my
bag which contained my walled which contained the
said Intellicare Health Card along with other personal
effects.

however they proved futile.
49. I now consider my Intellicare card along with

other belongings as lost and I am executing this
affidavit for whatever other legal purpose it may serve.


signature this February 24, 2014 in City of Manila.
MARIA KATREENA M. ESLAVA

Affiant
SUBSCRIBED AND SWORN to before me this February

24, 2014 in City of Manila after affiant exhibiting to me her
BIR ID No. 430985748
Doc. No. 286;

Page No. 59;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, APRONIANO S. SABIO III, Filipino, of legal age,
married and with postal address at , after having been
duly sworn to in accordance with law, do hereby depose
and say that:
51. I
52. My daughter took the UST College Entrance
Exam last 2013. And with that she was issued a
corresponding test permit where her examinee number
can be found.
53. Such test permit was placed by us in our home

where we usually place important documents.
54. This January, we tried to look for the said test

permit to check the examinee number with which we
can check the results of the entrance exam. However
we can no longer find the said test permit.
55. Diligent efforts were exerted to find the same;

56. The test permit is now considered lost and I am



signature this January 29, 2014 in City of Manila.
BERNADETTE C. ESTRADA
Affiant
SUBSCRIBED AND SWORN to before me this January

Company ID No. MTC-EN-134 -13.
Doc. No. 190;

Page No. 39;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, BERNADETTE C. ESTRADA, Filipino, of legal age,
married and with postal address at Unit 2901 Mezza
Residences corner Araneta Avenue Aurora Blvd. Quezon
City, after having been duly sworn to in accordance with
58. I am the mother of MAE DANALYN C.

ESTRADA, minor, single and residing at the same
address stated above.
59. My daughter took the UST College Entrance

Exam last 2013. And with that she was issued a
corresponding test permit where her examinee number
can be found.
60. Such test permit was placed by us in our home

where we usually place important documents.
61. This January, we tried to look for the said test

permit to check the examinee number with which we
can check the results of the entrance exam. However
we can no longer find the said test permit.
62. Diligent efforts were exerted to find the same;

63. The test permit is now considered lost and I am



BERNADETTE C. ESTRADA
Affiant

Company ID No. MTC-EN-134 -13.
Doc. No. 190;
Page No. 39;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, CRUZ, RESTITA HORCA, Filipino, of legal age,
married and with postal address at 1337 V. Concepcion St.
Sta. Cruz, Manila, after having been duly sworn to in
65. I am a holder of Philippine Passport with No.

EB0992109, issued in DFA Manila.
66. On December 20, 2013, I rode the LRT from Recto

Station to Araneta-Cubao and then the MRT from
Araneta-Cubao to Ayala Station carrying with me my
valuables.
67. Upon reaching my destination, I found my bag

slashed by a sharp object, making an opening and some
of the items inside were gone including my passport.
68. Diligent efforts were exerted to find the said

passport in case it was dropped on the way; however
they proved futile as I can no longer find the same.
69. I now consider the same as lost and I am



CRUZ, RESTITA HORCA

Affiant
SSS ID with number 33-2089013-3
Doc. No. 184;

Page No. 38;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, JEFFREY JOHN GE SANTOS ALEJANDRIA,
Filipino, of legal age, married and with postal address at
1432 Dos Castillos St. Sta. Cruz, Manila, after having
been duly sworn to in accordance with law, do hereby
depose and say that:
71. I was a graduate of Central Institute of

Technology and with that I was issued my School
Diploma sometime after I graduated. I kept my diploma
at home in the above stated address for safekeeping.
72. In lieu of the requirements for legal purposes, I

went home to retrieve my diploma. However it was no
longer in the place where I kept it.

diploma, however they proved futile as I can no longer
find the same.


JEFFREY JOHN GE SANTOS

ALEJANDRIA
Affiant

SSS ID with number 33-2192022-2.
Doc. No. 183;

Page No. 38;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, QUERUBIN, MAE JAPETH, Filipino, of legal age
and with postal address at Unit 209 Jaro Building,
Bonifacio Heights Condominium Lawton Avenue Fort
Bonifacio, Taguig City, after having been duly sworn to in
76. I was a graduate of St. Jude College and with that

I was issued my School Diploma sometime 2001. I kept
my diploma at home in the above stated address for
safekeeping.
77. In lieu of the requirements for application for

employment, I went home to retrieve my diploma.
However it was no longer in the place where I kept it.
diploma, however they proved futile as I can no longer
find the same.



QUERUBIN, MAE JAPETH

Affiant

PRC ID with number 0365756, issued in Manila, 2005
Doc. No. 182;

Page No. 38;
Book No. 17;
Series of 2014.

AFFIDAVIT OF LOSS
I, ANIMASOLA FERRER AQUINO, Filipino and with
postal address at No. 1172 E. Quintos Street, Sampaloc
Manila , after having been duly sworn to in accordance
with law, do hereby depose and say that:
81. I am a member of PAG-IBIG and I possess/own a
PAG-IBIG ID.
82. Sometime on December 2013, I placed the above-

mentioned ID inside my drawer at home.
83. However, when I was looking for the same, I can

no longer find the same. I exerted efforts to find it but
proved futile.



ANIMASOLA FERRER AQUINO

Affiant

SSS-ID with ID No. 33-7962940-7.
Doc. No. 123;

Page No. 26;
Book No. 17;
Series of 2014.
AFFIDAVIT OF LOSS
I, JOSE YU, of legal age, Filipino and with postal address at

1784 Alvarez St. Sta. Cruz, Manila, after having been duly sworn to in
86. On October 26, 2013 while I was in Binondo, Manila I

became a victim of a pick-pocket and my wallet was taken from
me.
87. In my wallet were personal effects including the following:
a. SSS ID
b. Postal ID
c. Naturalization ID
d. Senior Citizen ID
e. EZ Card for Supermarket
f. ATM Card
88. I now consider the same as lost and I am executing this

affidavit to have my cards replaced and for whatever legal
89. I am executing this Affidavit to attest the truthfulness of

IN WITNESS WHEREOF, I have hereunto affixed my signature

this 14th day of November 2013 in City of Manila.
JOSE YU
Affiant
SUBSCRIBED AND SWORN to before me this 14 th day of

November 2013 in City of Manila.
Doc. No. 507;

Page No. 103;
Book No. XVI;
Series of 2013.
AFFIDAVIT OF LOSS
I, NIKO A. MENDOZA, single married, Filipino and with

postal address at No. 19 Bayabas St. Antonio Subd. Dalandanan
Valenzuela City, after having been duly sworn to in accordance with
90. My wife MILANIE C. NEMIS and son MICJO C. NEMIS

were issued PHIL CARE Card sometime on January 2013.
91. I usually placed the above-mentioned cards inside my

drawer.
92. Recently, I tried to look for it at the same drawer but I can
no longer find the same.
93. I exerted all efforts to find the cards but it proved futile. I
now consider the same as lost.
94. I am executing this Affidavit to attest to the truthfulness of


this 20th day of September 2013 in City of Manila.
MILBERT R. NEMIS
Affiant
SUBSCRIBED AND SWORN to before me this 20 th day of

September 2013 in City of Manila. Affiant exhibiting to me his Drivers
License with ID No. C07-96-134779.
Doc. No. 314;
Page No. 64;
Book No. 16;
Series of 2013.

AFFIDAVIT OF LOSS
I, Romulo Gabriel A. Kintanar, single, Filipino and with

address at 146 Roosevelt Avenue San Francisco Del Monte, Quezon
City after having been duly sworn to in accordance with law, do
hereby depose and say that:
95. As the Vice President of the University of Santo Tomas

Central Student Council, I have in my custody official receipts
used by the Office of Student Affairs, for the materials for the
activity, Thomasian Leaders Congress.
96. I kept those receipts neatly on top of my desk at my home.
97. On May 28, 2013, I was asked by the officer in charge of

the committee to submit said receipts to her.
98. I immediately went looking for the said receipts but I can
no longer find the same.
99. I exerted efforts to find all the documents but efforts

proved futile.

this 16th day of May 2013 in City of Manila.
ROMULO GABRIEL A. KINTANAR

Affiant
SUBSCRIBED AND SWORN to before me this 29 th day of May

2013 in City of Manila affiant exhibiting to me his UST Student ID No.
2010-013382
Doc. No. 412;

Page No. 84;
Book No. 15;
Series of 2013.

AFFIDAVIT OF LOSS
I, Jose Antonio R. Sajor, single, Filipino and with address at

1777 Dapitan St. Sampaloc Manila, Manila after having been duly
sworn to in accordance with law, do hereby depose and say that:
101. On 2012, we bought QUBE DVR and in view thereof, we

were given QUBE Warranty Slip (DVR).
102. I kept the said warranty slip in my drawer.
103. Recently , when I was looking for the said warranty slip, I
can no longer find the same.
104. I exerted efforts to find all the documents but efforts
proved futile.


ROMULO GABRIEL A. KINTANAR

Affiant

2013 in City of Manila affiant exhibiting to me his UST Student ID No.
2010-013382
Doc. No. 412;

Page No. 84;
Book No. 15;
Series of 2013.

AFFIDAVIT OF LOSS
I, RAM CHRISTIAN C. MAPANOO, single, Filipino and with

office address at No. 930 JM Loyola Street, Carmona Cavite, after
having been duly sworn to in accordance with law, do hereby depose
and say that:
106. I am first year student at University of Santo Tomas.

107. As such, I was issued a Student Identification Card with
Student Id No. 2012-2048179.
108. I misplaced the above-mentioned identification card after

the school year (March).
109. Recently, I was trying to look for the above-mentioned

identification card, but I can no longer find the same. I exerted
efforts to find all the documents but efforts prove futile.


RAM CHRISTIAN C. MAPANOO

Affiant
BELINDA CANTINA CO
PARENT/ GUARDIAN

2013 in City of Manila affiant exhibiting to me his UST ID NO. 2012-
2048179.
Doc. No. 279 ;

Page No. 57 ;
Book No. 15
Series of 2013

Affidavit of Loss (Bank)

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REPUBLIC OF THE PHILIPPINES )

CITY OF MANILA) S.S.

1. I loaned an Apple Ipad 4 Wifi to MZE CELLULAR

2. Such receipt was placed by me in my wallet along with

3. On June 29, 2014 while I was looking for the said

4. Diligent efforts were exerted to recover the said Official

5. I now consider the said MZE CELLULAR PHONESHOP

6. I am executing this Affidavit to attest the truthfulness of

IN WITNESS WHEREOF, I have hereunto affixed my

NNYLEL EDRIAN GABRIEL

SUBSCRIBED AND SWORN to before me this 1st of

REPUBLIC OF THE PHILIPPINES )

7. I am bank customer of PNB Marulas Valenzuela as

8. I am in possession of the said PNB ATM Card;

9. Sometime in June 2014, I discovered that I could no

10. Diligent efforts were exerted to recover the said

11. I now consider the said PNB ATM Card as stolen

12. I am executing this Affidavit to attest the

IN WITNESS WHEREOF, I have hereunto affixed my

SUBSCRIBED AND SWORN to before me this July 1,

Doc. No. 336;

REPUBLIC OF THE PHILIPPINES )

13. I was a student of the University of Santo Tomas

14. As such I was issued a UST ID with student

15. Sometime 2010, I went to an agency Top Spot

16. Diligent efforts were exerted to recover the said

17. I now consider my UST ID as lost and I am

IN WITNESS WHEREOF, I have hereunto affixed my

KEVIN PATRICK BOLO

SUBSCRIBED AND SWORN to before me this June 3,

Doc. No. 209;

REPUBLIC OF THE PHILIPPINES )

19. I was given the Social Security No. 03-6707156-5

20. Such ID was placed by me in my wallet, along

21. Around May 2014, as I was looking for my SSS

22. Diligent efforts were exerted to recover the same,

23. I now consider such SSS ID as lost and I am

24. I am executing this Affidavit to attest the

IN WITNESS WHEREOF, I have hereunto affixed my

SUBSCRIBED AND SWORN to before me this May 13,

Doc. No. 31;

REPUBLIC OF THE PHILIPPINES )

26. As such I was issued by the above-stated bank an

27. On April 2014 the said China Bank Corporation

28. Diligent efforts were exerted to recover the same,

29. I now consider such China Bank Corporation ATM

30. I am executing this Affidavit to attest the

IN WITNESS WHEREOF, I have hereunto affixed my

SUBSCRIBED AND SWORN to before me this April 28,

Doc. No. 484;

31. At around 12:30p.m. on March 11, 2014, while I

32. That said wallet contained all my cards including

33. Diligent efforts were exerted to recover the same;

34. I now consider such wallet with my Firearms

35. I am executing this Affidavit to attest the

IN WITNESS WHEREOF, I have hereunto affixed my

CAMILA SIENNE H. LIM

SUBSCRIBED AND SWORN to before me this March

REPUBLIC OF THE PHILIPPINES )

36. At around 12:30p.m. on March 11, 2014, while I

37. That said wallet contained all my cards including

38. Diligent efforts were exerted to recover the same;

39. I now consider such wallet with my Drivers

40. I am executing this Affidavit to attest the