REPUBLIC OF THE PHILIPPINES )

MEYCAUAYAN, ) SS.

AFFIDAVIT OF LOSS

I, Uruy E. Urguy, Filipino, of legal age, single, and a resident of Marilao Bulacan,
after having been duly sworn in accordance with law, hereby depose and say:

1. That I am a holder of a Company ID issued by Logistics E Manpower

2. That I used to put said Company ID together with other personal documents
and identifications in my wallet.

3. That sometime in April 12, 2018, when I was trying to locate my wallet from
where I used to put said Company ID unfortunately I could not find it;.

4. Despite diligent efforts exerted during the day to find the said wallet including
my Company ID I could not find it, it is now lost beyond recovery;

5. I am executing this affidavit to attest to the truth of the foregoing and to request for its
replacement and to use it for all intents and legal purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 20th day of

April, 2018 at Meycauayan, Bulacan, Philippines.

___________________________
AFFIANT

Before me a Notary Public for and in Meycauayan, Bulacan, personally appeared

Uruy E. Urguy on April 20, 2018, who exhibited his Pag-IBIG ID, No. 2222222.

Notary Public
Doc. No. ……..;
Page No. …….;
Book No. …….;
Series of 2018.