Professional Documents
Culture Documents
City Of Santiago ) SS
AFFIDAVIT OF LOSS
I, Lucky Joy A. Domingo., of legal age, Filipino, single, and a resident of Cabulay, Santiago
City, after having duly sworn in accordance to law, hereby depose and state:
1. That I am the owner and holder of the following: a) Taxpayer’s Identification Card
issued by BIR; and B) PHILHEALTH CARD;
2. That I have always kept the said cards in my wallet which I always bring every
time I go out;
3. That my wallet and its contents including the abovementioned cards were
unfortunately lost sometime in November 24, 2014 at about 11:00 o’ clock in the
morning inside the office where I am working;
4. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
5. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost a) Professional
Identification Card (PRC); b) Taxpayer’s Identification Card; and c) PHILHEALTH
Card.
affiant
PRC ID No. 0350753
AFFIDAVIT OF LOSS
7. That I have always kept the said cards in my wallet which I always bring
everytime I go out;
8. That my wallet and its contents including the abovementioned cards were
unfortunately lost sometime in October 22, 2010 at about 11:00 o’ clock in the
morning inside my classroom where I am teaching;
9. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
10. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost a) Professional
Identification Card (PRC); b) Taxpayer’s Identification Card; and c) PHILHEALTH
Card.
NENITA A. ABARA
affiant
PRC ID No. 0350753
AFFIDAVIT OF LOSS
11. That I am the holder of Social Security System Identification Card and Social
Security System Identification Card of my sister, HILDA BAUTISTA;
12. That I have always kept the said cards in my wallet which I always bring
everytime I go out;
13. That my wallet and its contents including the abovementioned cards were
unfortunately lost;
14. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
15. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost Social Security System
Identification Card and Social Security System Identification Card of my sister,
HILDA BAUTISTA.
MARILYN B. JAVIER
affiant
DepEd I.D. No. 0021999
SUBSCRIBED AND SWORN to before me this 13th day of April, 2010 at Santiago
City, Philippines.
AFFIDAVIT OF LOSS
16. That I am the owner and holder of the following: a) PHILHEALTH Card with I.D.
No. 06-025020052-0 b) Firearm License; c) Permit to Carry Firearm License d)
Professional Driver’s License with No. N04-90-163886; e) Tax Identification No.
901-159-493; f) Social Security System I.D. No. 3303071597; and g) KABAYAN
ACTION GROUP I.D. No. 023638;
17. That I have always kept the said cards in my wallet which I always bring
everytime I go out;
18. That my wallet and its contents including the abovementioned cards were
unfortunately lost sometime in February 18,2010 at about 9:00 to 11:00 o’ clock
in the morning along Victory Norte, Victory Sur or Patul Road;
19. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
20. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost a) PHILHEALTH Card
with I.D. No. 06-025020052-0 b) Firearm License; c) Permit to Carry Firearm
License d) Professional Driver’s License with No. N04-90-163886; e) Tax
Identification No. 901-159-493; f) Social Security System I.D. No. 3303071597;
g) KABAYAN ACTION GROUP I.D. No. 023638.
IN WITNESS WHEREOF, I have hereunto set my hand this 20th day of February,
2010 at Santiago City.
AFFIDAVIT OF LOSS
21. That I am the owner and holder of the following: a) PHILHEALTH Card issued by
Philhealth Santiago City Branch, Santiago City; b) Barangay Intelligence Network
(BIN) Identification Card issued by Philippine National Police-Region 2; c)
Guardian’s Identification Card; d) Professional Driver’s License issued by LTO-
Santiago City;
22. That I have always kept the said cards in my wallet which I always bring
everytime I go out;
23. That my wallet and its contents including the abovementioned cards were
unfortunately lost sometime in January 22, 2010 at about 5:00 o’ clock in the
afternoon;
24. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
25. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost a) PHILHEALTH Card
issued by Philhealth Santiago City Branch, Santiago City; b) Barangay
Intelligence Network (BIN) Identification Card issued by Philippine National
Police-Region 2; c) Guardian’s Identification Card; d) Professional Driver’s
License issued by LTO-Santiago City.
AFFIDAVIT OF LOSS
I, MANUEL R. OIDEM, of legal age, Filipino, married, and a resident of 268 San
Jose St., Cabugao, Echague, Isabela, after having been duly sworn in accordance with
law, hereby depose and state:
26. That I am the owner and holder of the following: a) Professional Regulatory
Commission Identification Card issued by PRC Manila; b) ATM CARD issued by
Philippine National Bank (PNB); c) Company Identification Card issued by
Senator Crewing Manila; d) Residential Certificate issued by Manila; e)
Professional Driver’s License issued by LTO-Manila and f) Family Picture;
27. That I have always kept the said cards in my wallet which I always bring
everytime I go out;
28. That my wallet and its contents including the abovementioned cards were
unfortunately lost sometime in January 9, 2010 at about 1:00 o’ clock in the
afternoon at the tricycle from Echague going to Santiago City;
29. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
30. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost Professional Regulatory
Commission Identification Card , ATM CARD issued by Philippine National Bank
(PNB), Company Identification Card issued by Senator Crewing Manila,
Residential Certificate issued by Manila, and Professional Driver’s License
issued by LTO-Manila.
MANUEL R. OIDEM
affiant
AFFIDAVIT OF LOSS
1. That I am the owner and holder of check under check no. 0393656 with an
amount of FIFTEEN THOUSAND PESOS (P15,000.00) issued by Land Bank of
the Philippines, Ilagan, Isabela Branch, Ilagan, Isabela;
2. That I have always kept the said check in my wallet which I always bring
everytime I go out;
3. That my wallet and its contents including the abovementioned check was
unfortunately lost sometime in November 23, 2009 in Buenavista, Santiago City;
4. That I have exerted diligent efforts to locate my wallet including its contents but in
vain; hence, the same are now considered lost beyond recovery;
5. That I am executing this affidavit to attest to the truth of the foregoing and to
support of my application for the replacement of my lost check.
JOCELYN A. MAWIRAT
affiant
DepEd I.D. No. 05056
AFFIDAVIT OF LOSS
3. That when I returned, I found out that my wallet is no longer in the place where I
placed it earlier;
4. That I have tried all my effort to locate my wallet but in vain, hence, the same is
considered lost beyond recovery;
5. That I am executing this affidavit to attest to the truth of the aforementioned facts.
RAMON A. GOMBIO
affiant