REPUBLIC OF THE PHILIPPINES)

PROVINCE OF TARLAC ) S.S.

x--------------------------------------x

AFFIDAVIT OF LOSS

I, ALDRIN COLOMA MENDOZA, of legal age, Filipino and a resident at

Paniqui, Tarlac, after having been duly sworn to in accordance with law,
depose and state THAT:

1. That I am a holder of a wallet;

2. That inside the said wallet is my Postal I.D. issued by the PHLPOST –
Philippine Postal Corporation, Paniqui, Tarlac;

3. That on March, 2020, I lost/dropped the said wallet which contains the
above mentioned Postal I.D.;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification card, I could not find the same such that I
believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day of June

2020 in Paniqui, Tarlac Philippines.

ALDRIN COLOMA MENDOZA

Affiant
D04-12-128158

SUBCRIBED AND SWORN TO before me this 5th day of June 2020 in

Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, MARVIN PANGAN, of legal age, Filipino, married and a resident of

Paniqui, Tarlac, after having been duly sworn to in accordance with law,
depose and state:

1. That I am a holder of valid identification cards, to wit:

A. UMID I.D.
B. Senior Citizen I.D.
C. Tarelco I.D.
D. Land Bank ATM Card

2. That the above said Identification cards were put inside my wife’s wallet
for safe keeping;

3. That on May 8, 2019 at 10:00 o’clock in the morning while my wife was
in the Paniqui Public Market in Paniqui, Tarlac, the said wallet got lost;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards and cash, I could not find the same
such that I believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 8th day of May
2019 in Paniqui, Tarlac Philippines.

MARVIN PANGAN
Affiant

SUBCRIBED AND SWORN TO before me this 8th day of May 2019 in

Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, ROY ALVAREZ CANGMAONG, of legal age, Filipino, married and a

resident of Gerona, Tarlac, after having been duly sworn to in accordance with
law, depose and state:

1. That I am a holder of wallet;

2. That inside the said wallet are my belongings, to wit:

a. Two (2) ATM Card - Banco de Oro

b. Security Bank
c. Driver’s License (KSA/LOCAL)
d. Nine Thousand Pesos (P9,000.00)

3. That on June 15, 2019 the said wallet was drop and got lost;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards and cash, I could not find the same
such that I believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 21 st day of June

2019 in Paniqui, Tarlac Philippines.

ROY ALVAREZ CANGMAONG

Affiant
Passport: P1128091A

SUBCRIBED AND SWORN TO before me this 21st day of June 2019 in

Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, EDMOND ROMBAOA, of legal age, Filipino, married and a resident of

Paniqui, Tarlac, after having been duly sworn to in accordance with law,
depose and state:

1. That I am a holder of wallet;

2. That inside the said wallet are my belongings, to wit:

a. PhilHealth ID
b. Driver’s License
c. OneThousand Three Hundred Pesos (P1,300.00)

3. That on July 24, 2019 the said wallet was drop and got lost;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards and cash, I could not find the same
such that I believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 25th day of July
2019 in Paniqui, Tarlac Philippines.

EDMOND ROMBAOA
Affiant

SUBCRIBED AND SWORN TO before me this 25th day of July 2019 in

Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, MICHAEL OBISPADO TULIAO, of legal age, Filipino, married and a

resident of Paniqui, Tarlac, after having been duly sworn to in accordance with
law, depose and state:

1. That I am a holder of black leather wallet;

2. That inside the said wallet are my belongings, to wit:

d. PhilHealth ID
e. Driver’s License
f. OneThousand Three Hundred Pesos (P1,300.00)

3. That on July 24, 2019 the said wallet was drop and got lost;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards and cash, I could not find the same
such that I believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 25th day of July
2019 in Paniqui, Tarlac Philippines.

EDMOND ROMBAOA
Affiant

SUBCRIBED AND SWORN TO before me this 25th day of July 2019 in

Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, RHEYNAN S. MONFORTE, of legal age, Filipino, single and a resident of

Abagon, Gerona, Tarlac, after having been duly sworn to in accordance with
law, depose and state:

1. That I am a holder of a wallet;

2. That inside the said wallet are my belongings, to wit:

A. SSS (Social Security System) I.D.

B. PhilHealth I.D.v
C. Pag-Ibig ID.
D. TIN I.D.
E. Sutherland Employee I.D.

3. That on December, 2019, the said wallet was dropped and got lost while
riding on a tricycle on my way home at Abagon Gerona Tarlac;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards, I could not find the same such that I
believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 24 th day of

January 2020 in Paniqui, Tarlac Philippines.

RHEYNAN S. MONFORTE
Affiant

SUBCRIBED AND SWORN TO before me this 24th day of January 2020

in Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, JEFFREY B. MABANGLO, of legal age, Filipino, single and a resident of

Paniqui, Tarlac, after having been duly sworn to in accordance with law,
depose and state:

1. That I am a holder of wallet;

2. That inside the said wallet are my belongings, to wit:

A. FOUR HUNDRED PESOS (P400.00)

B. Driver’s License.
C. Voter I.D.
D. SUKI CARD.

3. That on February 20, 2020 in the morning while I was driving along the
highway on my way home the said wallet was missing;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards and cash, I could not find the same
such that I believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day of

February 2020 in Paniqui, Tarlac Philippines.

JEFFREY B. MABANGLO
Affiant

SUBCRIBED AND SWORN TO before me this 20th day of February 2020

in Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, JESREN M. COMEDIA, of legal age, Filipino, single and a resident of

Gerona, Tarlac, after having been duly sworn to in accordance with law, depose
and state:

1. That I am a holder of wallet;

2. That inside the said wallet are my belongings, to wit:

a. Driver’s License.
b. TIN I.D.
c. PHILHEALTH I.D.

3. That on February 19, 2020 in the afternoon while I was driving along the
highway on my way home the said wallet was missing;

4. That despite diligent search and efforts to locate the said wallet including
the above said identification cards, I could not find the same such that I
believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day of

February 2020 in Paniqui, Tarlac Philippines.

JESREN M. COMEDIA
Affiant

SUBCRIBED AND SWORN TO before me this 20th day of February 2020

in Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, HERMINIO F. MENDOZA, of legal age, Filipino, single and a resident of

Gerona, Tarlac, after having been duly sworn to in accordance with law, depose
and state:

1. That I am a holder of wallet;

2. That inside the said wallet are my belongings, to wit:

a. Driver’s License.
b. Banco De Oro Debit Card
c. Official Receipt and Certificate of Registration of motor vehicle

3. That on March 12, 2020 in the afternoon while I was driving along the
highway on my way home the said wallet was missing;

4. That despite diligent search and efforts to locate the said wallet
including the above said identification cards, I could not find the
same such that I believe that it is now lost beyond recovery;

5. That as such, I am executing this affidavit to attest to the foregoing

facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of

March 2020 in Paniqui, Tarlac Philippines.

HERMINIO F. MENDOZA.
Affiant

SUBCRIBED AND SWORN TO before me this 13th day of March2020 in

Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF TARLAC ) S.S.
x--------------------------------------x

AFFIDAVIT OF LOSS

I, JACK DANIEL DE LEON LOPEZ, of legal age, Filipino and a resident

at Lot 11, Blk. 10, Pascual St., Robertsville, Matatalaib, Tarlac City, after
having been duly sworn to in accordance with law, depose and state THAT:

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 IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of
________________________ in Paniqui, Tarlac Philippines.

JACK DANIEL DE LEON LOPEZ

Affiant

SUBCRIBED AND SWORN TO before me this ____ day of

________________________ in Paniqui, Tarlac Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.