Republic of the Philippines ) Camiling, Tarlac ) S.S.

AFFIDAVIT OF LOSS
___________________ I, EMILINDA A. MANUEL, of legal age, married, Filipino and a resident of #363 Palimbo Caarosipan, Camiling, Tarlac, after having been duly sworn in accordance with law do hereby depose and allege; 1. That on April 15, 2010, on or about 8:00 oclock in the morning, I lost my wallet while I was driving my motorcycle bound for Camiling Public Market. My wallet that I lost contains the following items: Professional Drivers License and Social Security System ID. 2. That despite efforts on my part to locate the above-mentioned missing items by asking my relatives if I dropped my wallet inside our house but they were never found or returned to me. 3. That I am executing this affidavit for purposes of informing all concerned agencies and offices about the loss of my professional Drivers License and SS ID for the purpose of securing their replacement. 4. That my drivers license and SS ID were never transferred, pledged or used as a security to any transaction or obligation. 5. That I am executing this Affidavit to attest to the truth of the foregoing statement and for whatever legal purposes and intents it may serve IN WITNESS WHEREOF, I hereunto affix my signature this 19th day of April 2010 in Camiling, Tarlac. EMILINDA A. MANUEL Affiant SUBSCRIBED AND SWORN to before me on the date and place indicated above. Affiant exhibited to me her Postal Identification Card with No. 9246978 issued at Camiling, Tarlac.