Republic of the Philippines)

Malaybalay City, Bukidnon) S.S

AFFIDAVIT OF LOSS

I, CHRISTOPER D. CASTOR, of legal age, single, Filipino citizen and a

resident of Purok 1, Caboluhan, Cabanglasan, Bukidnon after having been duly
sworn to an oath in accordance with law, hereby depose and say:

1. That I am a depositor of One Network Bank, Malaybalay City Branch;

2. That as such I was issued by the said Bank a passbook under Account
No. 040690034210;

3. That sometime in August 2017, the said passbook was lost in my

possession;

4. That all efforts were exerted to look for the passbook, but it proved futile
and it is beyond recovery;

5. That I am attesting to the truth and veracity of the foregoing facts;

6. That I am voluntarily executing this affidavit for whatever legal purpose/s

it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 22nd day of

August 2018 at Malaybalay City, Bukidnon.

CHRISTOPER D. CASTOR
Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of August, 2018 at

Malaybalay City, Bukidnon, Philippines. Affiant exhibited to me his UMID No.
CRn-006-0034-7224-4 issued at Malaybalay City, Bukidnon. I HEREBY CERTIFY
that I have personally examined the affiant and I am satisfied that he voluntarily
executed and understood this affidavit.

Doc. No. ______

Page No. ______
Book No. ______
Series of 2018