AFFIDAVIT OF LOSS

REPUBLIC OF THE PHILIPPINES)

CITY OF DIPOLOG ) S.S
x---------------------------------------x

I, NOBBIN CAERMARE ESIC of legal age, Filipino, married and a resident of

Bougainvilla, Sicayab, Dipolog City, Zamboanga del Norte, after having been duly
sworn to in accordance with law, depose and state:

1. THAT I am the holder of ATM card issued by BDO, Dipolog City with an account
no. 010270019189;
2. THAT sometime on April 17,2017 the said ATM Card was misplaced and got
lost;

3. THAT thereafter, I discovered that my ATM Card was lost and missing and
despite effort to recover it, the said ATM Card was presumed lost for all legal
intent and purposes;

4. That I am executing this affidavit in order to request the office of BDO for the
issuance of a new ATM Card in lieu of the one which was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 31st day of May, 2017 at
Dipolog City.

NOBBIN CAERMARE ESIC

Affiant

SUBSCRIBED AND SWORN to before me, this 31st day of May, 2017 in Dipolog City,
with affiant exhibiting his PRC ID No. 0357125. Issued on April 5,2004 at Pagadian City.

NOTARY PUBLIC

Doc. No. :__

Page No. :__
Book No. :___
Series of 2017.
 REPUBLIC OF THE PHILIPPINES)
CITY OF DIPOLOG ) S.S.
x-------------------------------------x

AFFIDAVIT OF LOSS

I, IRISH A. CIMAFRANCA, of legal age, Filipino, single and a resident of

Isis,Polanco, Zamboanga del Norte after having been duly sworn to in accordance with
law, depose and state:

1. That I am a graduating student of STI Dipolog

2. That despite diligent effort to locate all my school records particularly FORM-137 the
said records were either lost or misplaced and presumed to be missing as I took it for
granted ;

3. That considering that I am graduating this school year I was required to submit all my
financial school records thus I was constrained to submit the said records to the
school authorities;

5. That in view thereof, I am now executing this affidavit to support my graduation papers
as required by the school and for any legal purpose it may served

IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of March
2017 in Dipolog City, Philippines.

IRISH A. CIMAFRANCA
Affiant
Student ID No. 135-0163-2014

SUBCRIBED AND SWORN TO before me this 15th day of March 2017 in Dipolog
City, Philippines, affiant exhibiting to me his valid proof of identification.

Doc. No. 19;

Page No. 4;
Book No. 1;
Series of 2017

1. I had earnestly tried to look for the said Pantawid ID but the same could not be found;
2. Despite diligent search and effort to locate the said ID, I could not find the same such
that I believe that it is now lost beyond recovery;