Republic of the Philippines )

City of Zamboanga . . . . . . . )s.s.

x. . . . . . . . . . . . . . . . . . x

AFFIDAVIT OF MUTILATION

I, ELIA A. PONTEES, of legal age, married, Filipino citizen

and a resident of San Roe, Anga City, Philippines, under oath,
depose and state:

That I am the holder of a Philippine Passport bearing No.

P099999X issued by the Department of Foreign Affairs Regional
Consular Office, Anga City on March 06, 2019, which will expire
on March 05, 2029;

That I was not able to used said passport;

That said passport was kept inside a bag in my room

cabinet, sometime in April 2019 when I check the said passport I
noticed that the said passport was damaged/mutilated due to
termite bites;

That the damage on the said passport has rendered it

unusable for travel purposes and thereof, I am now applying for
its renewal/replacement;

That I am executing this affidavit to attest to the

veracity of the foregoing facts and to support my application
for its replacement with the Department of Foreign Affairs
Zamboanga Regional Consular Office, Anga City

IN WITNESS WHEREOF, I have hereunto set my hand this 16th

day of May 2019 in the City of Anga, Philippines.

ELIA A. PONTEES
Affiant

SUBSCRIBED AND SWORN to before me this 16th day of May 2019

in the City of Anga, Philippines. Affiant exhibited to me her
Philippine passport as indicated above.

Doc. No. ;
Page No. ; NOTARY PUBLIC
Book No. ;
Series of 2019.