REPUBLIC OF THE PHILIPPINES)

PROVINCE OF NUEVA VIZCAYA) S.S.

MUNICIPALITY OF BAYOMBONG)

AFFIDAVIT OF LOSS

I, JOY ANNE S. ESTEBAN, of legal age, married, Filipino citizen, and a

resident of Brgy. Salvacion, Bayombong, Nueva Vizcaya, after having been duly
sworn to in accordance with law hereby depose and state THAT:

1. I am in physical possession of an Acer Laptop having been issued by the

General Services Office (GSO) in favor and under the name of Mary Jane
A. Boy;

2. The aforesaid Laptop is customarily used in the Office of the

Sangguniang Bayan of Bayombong, Nueva Vizcaya by any of the Staffs
since its issuance. On May 4, 2018, I was in possession of the laptop
until yesterday May 7, 2018 before its unexpected lost;

3. At about 10:00 in the morning of May 7, 2018, I placed the Acer Laptop
on my table and afterwards, I then busied myself in doing my paper
works;

4. Nevertheless, this morning of May 8, 2018, I just found out that the said
laptop was no longer on top of my office table inside the Office of
Sangguniang Bayan, Bayombong, Nueva Vizcaya ;

5. Despite earnest efforts exerted to find the Acer Laptop, I failed to recover
the same and for which reason I hereby declare that it is now deemed
lost and beyond recovery;

6. I attest to the veracity of the foregoing statements and hereby execute

this Affidavit of Loss for whatever legal purposes it may duly serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this affidavit this

th
8 day of May 2018 at Bayombong, Nueva Vizcaya.

JOY ANNE S. ESTEBAN

Affiant
Employment (LGU Bayombong,
Nueva Vizcaya) I.D. No. 1021-26

SUBSCRIBED AND SWORN TO before me this 8th day of May at

Bayombong, Nueva Vizcaya, affiant having exhibited to me her competent
evidence of identity, indicated below her name and signature.