Republic of the Philippines)

City of Manila -----------------) S.S.

AFFIDAVIT OF LOSS

I, _________________________ , of legal age, single,

Filipino Citizen and a resident at 2029 Agosto Francisco St.,
Sta. Ana Manila, after having been duly sworn to in
accordance with law do hereby voluntarily depose and state
that:

1. I am the holder of Philippine Postal ID which I secured

sometime in March 2017 at Sta. Ana Post Office

2. I was surprised to have known that my ID was not in

my bag where I placed it.

3. Diligent efforts have already been exerted to locate

said ID, but all turned out futile;

4. That said Philippine Postal ID was not confiscated by

the authorities of company / agency by reason of any
violation of company/ agency rules and regulations;

5. This affidavit is executed to certify the loss of the

abovementioned I.D. and for any legal purpose it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand

this April 30, 2018 in the City Manila.

______________________
Affiant

SUBSCRIBED AND SWORN to before me, Notary

Public for and in the City of Manila this April 30, 2018, affiant
exhibiting to me her _________________________ as competent
evidence of her identity.

Doc. No.____;
Page No.____;
Book No.____;
Series of 2018.