0% found this document useful (0 votes)

36 views

Mutilation of Passport

Uploaded by

pintolawspbranch

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as DOCX, PDF, TXT or read online on Scribd

0% found this document useful (0 votes)

36 views

Mutilation of Passport

Uploaded by

pintolawspbranch

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as DOCX, PDF, TXT or read online on Scribd

You are on page 1/ 718

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF MUTILATION

I, KRISTINE JOY RECRIO CARERAS, of legal age, Filipino, and

a resident of Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of PHILIPPINE PASSPORT with passport

no.P4394651A duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT was damage due to

flood last December 2017 that the cause of the mutilation of my passport;

That I am executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

02 nd
day of April 2018 at Davao City, Philippines

KRISTINE JOY RECRIO CARERAS

Affiant
Competent Proof of Identity:
PASSPORT No.: P4394651A

SUBSCRIBED AND SWORN to before me this 02nd day of April

2018 at Davao City, Philippines

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2018.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF MUTILATION

I, LOLITA RECRIO CARERAS, of legal age, Filipino, married,

and a resident of Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am the holder of PHILIPPINE PASSPORT with passport

no.EC7235132 duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT was damage due to

flood last December 2017 that the cause of the mutilation of my passport;

That I am executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

02 nd
day of April 2018 at Davao City, Philippines

LOLITA RECRIO CARERAS

Affiant
Competent Proof of Identity:
PASSPORT No.: EC7235132

SUBSCRIBED AND SWORN to before me this 02nd day of April

2018 at Davao City, Philippines

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2018.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF MUTILATION

I, JOHAIR SAUD HADJI ALAWI, of legal age, Filipino, married,

and a resident of 251 Miniforest, Brgy.23-C, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby
depose and state:

That I am the holder of PHILIPPINE PASSPORT with passport

no.EC8466757 duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT was put in my pants

pocket and got washed that the cause of the mutilation of my passport;

That I am executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

07th day of March 2018 at Davao City, Philippines

JOHAIR SAUD HADJI ALAWI

Affiant
Competent Proof of Identity:
PASSPORT No.: EC8466757

SUBSCRIBED AND SWORN to before me this 07th day of March

2018 at Davao City, Philippines

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2018.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF MUTILATION

I, RAHIMA K. GUZMAN, of legal age, Filipino, married, and a

resident of Purok 01, Muslim Village, KM.11, Sasa, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of PHILIPPINE PASSPORT with passport

no. duly issued by Department of Foreign
Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT was gutted by fire

during the fire incident that transpired last November 24, 2017 that the
cause of the mutilation of my passport and also my son PHILIPPINE
PASSPORT namely RAHNIEL K. GUZMAN;

That I am executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

02nd day of February 2018 at Davao City, Philippines

RAHIMA K. GUZMAN
Affiant
Competent Proof of Identity:
PASSPORT No.:

SUBSCRIBED AND SWORN to before me this 02nd day of February

2018 at Davao City, Philippines

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2018.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF MUTILATION

I, PRINCESS RENOMERON ESCOTON, of legal age, Filipino,

single, and a resident of Purok 02, Nangka St., Tugbok, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of PHILIPPINE PASSPORT with passport

no. EC6410436 duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT was put inside my

bag and accidentally my soft drinks was opened and spilled that the
cause of the mutilation of my passport;

That I am executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of January 2018 at Davao City, Philippines

PRINCESS RENOMERON ESCOTON

Affiant
Competent Proof of Identity:
PASSPORT No.: EC6410436

SUBSCRIBED AND SWORN to before me this 20th day of January

2018 at Davao City, Philippines

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2018.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF MUTILATION

I, CHATTY MAY ALOYON DELA CERNA, of legal age, Filipino,

married, and a resident of Purok Centro Bobonao, Baganga, Davao
Oriental, Philippines, after having been duly sworn to in accordance with
law, do hereby depose and state:

That I am the holder of PHILIPPINE PASSPORT with passport no.

EB6411460 duly issued by Department of Foreign Affairs (DFA), Davao
City;

That the aforesaid PHILIPPINE PASSPORT was put inside my bag

and that my son saw my passport and that accidentally tear my passport
and that the cause of the mutilation of my passport;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11TH day of February 2016 at Davao City, Philippines
CHATTY MAY ALOYON DELA CERNA
Affiant
Competent Proof of Identity:
PASSPORT No.: EB6411460

SUBSCRIBED AND SWORN to before me this 11TH day of February

2016 at Davao City, Philippines

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GRACE GRANADA WENCESLAO, of legal age, Filipino, and a

resident of General Santos City, Philippines, and UNDER OATH do hereby
depose and say:
That I am a holder of OFFICIAL RECEIPT OF CASH BOND duly
issued by Boardwalk Ventures, Inc., Davao City;

That the aforesaid OFFICIAL RECEIPT OF CASH BOND has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13 day of January 2016, at Davao City, Philippines
th

GRACE GRANADA WENCESLAO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2018
Series of 2016. Roll of Attorney’s No. 54826
PTR OR. No. 6542931-12/15/15- Davao
City
IBP OR. No. 0980059-12/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, JOEBERT P. LACEA, of legal age, Filipino, and a resident of General

Santos City, Philippines, and UNDER OATH do hereby depose and say:

That I am a holder of CLAIM SLIP duly issued by Professional

Regulation Commission (PRC), Davao City;

That the aforesaid CLAIM SLIP has been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13th day of January 2016, at Davao City, Philippines

JOEBERT P. LACEA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, AMIRAH A. ABDULLAH, of legal age, Filipino, and a resident of

Davao City, Philippines, 8000, and UNDER OATH do hereby depose and
say:

That I am a holder of PAWN PAPER duly issued by EURO CIRCLE

PAWNSHOP, San Pedro, Davao City;

That the aforesaid PAWN PAPER has been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 TH
day of January 2016, at Davao City, Philippines

AMIRAH A. ABDULLAH
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2018
Series of 2016. Roll of Attorney’s No. 54826
PTR OR. No. 6542931-12/15/15- Davao
City
IBP OR. No. 0980059-12/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, VAL FIGUERAS ALBAERA, of legal age, Filipino, and a resident of

Davao City, Philippines, 8000, and UNDER OATH do hereby depose and
say:

That I am a holder of FORM 138 duly issued by Daniel R. Aguinaldo

National High School, Davao City;

That the aforesaid FORM 138 has been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines
VAL FIGUERAS ALBAERA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, VAL FIGUERAS ALBAERA, of legal age, Filipino, and a resident of

Davao City, Philippines, 8000, and UNDER OATH do hereby depose and
say:

That I am a holder of FORM 138 duly issued by Daniel R. Aguinaldo

National High School, Davao City;

That the aforesaid FORM 138 has been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 TH
day of January 2016, at Davao City, Philippines

VAL FIGUERAS ALBAERA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARICHU LIONG, of legal age, Filipino, and a resident of Davao

City, Philippines, 8000, and UNDER OATH do hereby depose and say:
That I am a holder of COMPANY IDENTIFICATION CARD (ID) duly
issued by KANTAR WORLDPANEL, Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD (ID) has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 TH
day of January 2016, at Davao City, Philippines

MARICHU LIONG
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ARLENE L. JAICTIN, of legal age, Filipino, and a resident of Davao

City, Philippines, 8000, and UNDER OATH do hereby depose and say:

That I am the daughter of the late ARTURO LABRADOR JR. a

holder of CERTIFICATE OF AUTHORIZING REGISTRATION (CAR) WITH
NO. 00107806 duly issued by Bureau of Internal Revenue (BIR), Davao
City;

That the aforesaid CERTIFICATE OF AUTHORIZING

REGISTRATION (CAR) WITH NO. 00107806 has been inadvertently lost
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH
day of January 2016, at Davao City, Philippines

ARLENE L. JAICTIN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JENILYN GARING BALICOG, of legal age, Filipino, and a resident of

Prk 16, STo. Niño, Crossing Bayabas Toril, Davao City, Philippines, 8000,
and UNDER OATH do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Manila;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines

JENILYN GARING BALICOG

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ADESAN CHANDRASEKAR, of legal age, Indian National, and a

resident of #12 Danao St., Rivera Village, Brgy. Gov. Paciano Bangoy,
Agdao District, Davao City, Philippines, 8000, and UNDER OATH do hereby
depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Davao Medical School Foundation, Inc., Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
12TH day of January 2016, at Davao City, Philippines

ADESAN CHANDRASEKAR
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ZENAIDA P. SUMADIA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of APPOINTMENT OF TEACHER I SUBSTITUTE

DOCUMENT duly issued by Department of Education (DEPED), Davao
City;

That the aforesaid APPOINTMENT OF TEACHER I SUBSTITUTE

DOCUMENT has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines

ZENAIDA P. SUMADIA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ILYN JOY SARDIDO Mother of LEOFRANCIS JIREH S. SARDIDO,

of legal age, Filipino and a resident of Davao City, after having been duly
sworn to in accordance with the law, do hereby depose and say:

That my son is a holder of SCHOOL IDENTIFICATION CARD (ID)

duly issued by Christian Colleges of Southern Asia, Maa, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines
ILYN JOY SARDIDO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ILYN JOY SARDIDO Mother of LEOFRANCIS JIREH S. SARDIDO,

of legal age, Filipino and a resident of Davao City, after having been duly
sworn to in accordance with the law, do hereby depose and say:

That my son is a holder of SCHOOL IDENTIFICATION CARD (ID)

duly issued by Christian Colleges of Southern Asia, Maa, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines

ILYN JOY SARDIDO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARLITO B. SITON, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:
That I am a holder of COMPANY IDENTIFICATION CARD (ID) duly
issued by CrisMark Manpower Services Agency, Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD (ID) has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines

CARLITO B. SITON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARLITO B. SITON, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of COMPANY IDENTIFICATION CARD (ID) duly

issued by CrisMark Manpower Services Agency, Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD (ID) has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 TH
day of January 2016, at Davao City, Philippines

CARLITO B. SITON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARLITO B. SITON, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of COMPANY IDENTIFICATION CARD (ID) duly

issued by CrisMark Manpower Services Agency, Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD (ID) has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 TH
day of January 2016, at Davao City, Philippines

CARLITO B. SITON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LLOYD CELERINOS, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of T.O.P. duly issued by Land Transportation

Office (LTO), Davao City;

That the aforesaid T.O.P. has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
12TH day of January 2016, at Davao City, Philippines

LLOYD CELERINOS
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, OLIVER FRANCISCO PERATER, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of SCHOOL, GOVERNMENT AND PRIVATE

IDENTIFICATION CARD’S duly issued by University of the Philippines,
Diliman, Quezon City, University of Mindanao, Main Branch, Philhealth,
Value Care here in Philippines;

That the aforesaid SCHOOL, GOVERNMENT AND PRIVATE

IDENTIFICATION CARD’S has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines

OLIVER FRANCISCO PERATER

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, OLIVER FRANCISCO PERATER, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of ATOMATED TELLER MACHINE CARD (ATM)

duly issued by Allied Bank, San, Pedro branch, Davao City;

That the aforesaid ATOMATED TELLER MACHINE CARD (ATM)

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines
OLIVER FRANCISCO PERATER
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROLAND C. REYES, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. N11080661Q duly issued by St. Peter Life Plan, Inc.,
Davao City;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. N11080661Q has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of January 2016, at Davao City, Philippines

ROLAND C. REYES
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARIA MENDEZ PREMACIO, of legal age, Filipino and a resident
of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PASSBOOK duly issued by Panabo Multi-

Purpose Cooperative, Davao City and ____________________________;

That the aforesaid PASSBOOK have been inadvertently lost and

despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of January 2016, at Davao City, Philippines
th

MARIA MENDEZ PREMACIO-

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEOPOLDO L. AMBUT JR., of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of CERTIFICATE OF PROFICIENCY (COP)

WITH NO. 27-306067 duly issued by GPN International Maritime Training
Center, Inc., Davao City;

That the aforesaid CERTIFICATE OF PROFICIENCY (COP) WITH

NO. 27-306067 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11th day of January 2016, at Davao City, Philippines

LEOPOLDO L. AMBUT JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of January
2016, at Davao City, Philippines.
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NENITA D. MARAÑON, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD WITH ACCT. NO. 109593105102, CARD #9561355306014
nad GSIS CARD NO. 42033100498;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

WITH ACCT. NO. 109593105102, CARD #9561355306014 nad GSIS
CARD NO. 42033100498 have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
11th day of January 2016, at Davao City, Philippines

NENITA D. MARAÑON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of January
2016, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JULIE ANNE M. PORSUELO, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign (DFA), Davao City;
That the aforesaid PHILIPPINE PASSPORT have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2016, at Davao City, Philippines

JULIE ANNE M. PORSUELO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARK HENJIE PARADO CUIZON, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of COMPANY IDENTIFICATION CARD (ID) duly

issued by LTS Supermarket Inc., Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD (ID) have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2016, at Davao City, Philippines

MARK HENJIE PARADO CUIZON

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALLAN CARASO SIBUGAN, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PURCHASE ORDER with no. 807666 and

823950 duly issued by LTS Community Store, Davao City;

That the aforesaid PURCHASE ORDER with no. 807666 and

823950 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2016, at Davao City, Philippines

ALLAN CARASO SIBUGAN

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NOVENS MURCIA BALSA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Chinabank, Matina branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th
day of January 2016, at Davao City, Philippines

NOVENS MURCIA BALSA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KRISTINE MAE CASTRO SANIEL, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Robinson’s Bank, Lanang Branch, Davao City;
That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2016, at Davao City, Philippines

KRISTINE MAE CASTRO SANIEL

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, DOMINADOR ANDORA NATIVIDAD JR., of legal age, Filipino

and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2016, at Davao City, Philippines

DOMINADOR ANDORA NATIVIDAD JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHARLOTTE MARIE Q. APORTADERA, of legal age, Filipino and

a resident of Davao City, after having been duly sworn to in accordance
with the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Landbank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of January 2016, at Davao City, Philippines

CHARLOTTE MARIE Q. APORTADERA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of January 2016,
at Davao City, Philippines.
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, IBRAHIM ATAU BIN REMUD, of legal age, Malaysian and a

resident of Block 27 Lot 27 Purok 3 Rambutan St., Green Meadows, Mintal,
Davao City after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of SIM CARD with No. 09089086666 duly

issued by Smart Communication, Davao City;

That the aforesaid SIM CARD with No. 09089086666 have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH
day of January 2016, at Davao City, Philippines

IBRAHIM ATAU BIN REMUD

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RISANA MONTOYO LIRAZAN, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of CLAIM STUB OF PRC ID duly issued by PRC,

Davao City;
That the aforesaid CLAIM STUB OF PRC ID have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of January 2016, at Davao City, Philippines

RISANA MONTOYO LIRAZAN

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of January 2016,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ARLENE R. TIAGO, of legal age, Filipino and a resident of Davao
City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of OFFICIAL RECEIPT (OR) WORTH

PHP499.00 duly issued by Unitop, San Pedro, Davao City;

That the aforesaid OFFICIAL RECEIPT (OR) WORTH PHP499.00

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of December 2015, at Davao City, Philippines

ARLENE R. TIAGO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, OMERAH JEDANIA HADJI DATU SURAIK, of legal age, Filipino

and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT WITH PASSPORT

NO. XX5010079 duly issued by Department of Foreign Affairs (DFA),
Cotabato City;

That the aforesaid PHILIPPINE PASSPORT WITH PASSPORT NO.

XX5010079 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of December 2015, at Davao City, Philippines

OMERAH JEDANIA HADJI DATU SURAIK

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ABRAHAM SACAY BUNAL, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) duly

issued by SSS, Davao City and PHILHEALTH ID duly issued by Philhealth,
Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) and

PHILHEALTH ID have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of December 2015, at Davao City, Philippines
ABRAHAM SACAY BUNAL
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MONIRA THERESE AÑASCO LOPEZ, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by DBP, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21st day of December 2015, at Davao City, Philippines

MONIRA THERESE AÑASCO LOPEZ

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, VAN HARIN AQUINO CENIA, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am a holder of DEBIT CARD WITH ACCOUNT NO.
100658059640 duly issued by Unionbank, Victoria Plaza Mall Branch,
Davao CIty;

That the aforesaid DEBIT CARD WITH ACCOUNT NO.

100658059640 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21st day of December 2015, at Davao City, Philippines

VAN HARIN AQUINO CENIA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, EDNA P. DIOMABOC, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of MAS CERTIFICATE duly issued by DepEd,

Manila;

That the aforesaid MAS CERTIFICATE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21 day of December 2015, at Davao City, Philippines
st

EDNA P. DIOMABOC
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, SAMUEL C. AQUINO SR., of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SENIOR CITIZEN IDENTIFICATION CARD

(ID) duly issued by OSCA, Davao City;

That the aforesaid SENIOR CITIZEN IDENTIFICATION CARD (ID)

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21st day of December 2015, at Davao City, Philippines

SAMUEL C. AQUINO SR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY FLOR E. MILLAR, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of EMPLOYEE’S HANDBOOK, CODE OF

BUSINESS ETHICS and INTELLICARE BOOK duly issued by Mindanao
Shopping Destination Corp, SM City Davao, Davao City;

That the aforesaid EMPLOYEE’S HANDBOOK, CODE OF

BUSINESS ETHICS and INTELLICARE BOOK have been inadvertently
lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
17th day of December 2015, at Davao City, Philippines

MARY FLOR E. MILLAR

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOVELYN E. VEQUIZO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PASSBOOK duly issued by Agdao Multi-

Purpose Cooperative, Davao City;
That the aforesaid PASSBOOK have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of December 2015, at Davao City, Philippines
th

JOVELYN E. VEQUIZO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, RAYMUND CAMARILLO ALBORES, of legal age, Filipino and a
resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PHILHEALTH ID, SSS ID, DRIVER’S

LICENSE, PNB ATM CARD and BDO ATM CARD;

That the aforesaid PHILHEALTH ID, SSS ID, DRIVER’S LICENSE,

PNB ATM CARD and BDO ATM CARD have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of December 2015, at Davao City, Philippines
th

RAYMUND CAMARILLO ALBORES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, RAYMUND CAMARILLO ALBORES, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD AND IDENTIFICATION CARD duly issued by One Network Bank
(ONB), Davao City

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of December 2015, at Davao City, Philippines
th

ALBERTO T. ABELLANA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ABDULLAH-BEDERI J. MALI, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER duly issued by

_______________________________, Davao City

That the aforesaid PAWNPAPER have been inadvertently lost and

despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17th day of December 2015, at Davao City, Philippines
ABDULLAH-BEDERI J. MALI
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALBERTO T. ABELLANA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by One Network Bank (ONB), Davao City

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17th day of December 2015, at Davao City, Philippines

ALBERTO T. ABELLANA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LUDIVICO G. GORDONCILLO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:
That I am a holder of SSS ID, DRIVER’S LICENSE, VOTER’S ID,
and PHILHEALTH ID duly issued by government and non-government
agencies concerned, Davao City

That the aforesaid SSS ID, DRIVER’S LICENSE, VOTER’S ID, and
PHILHEALTH ID have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of December 2015, at Davao City, Philippines
th

LUDIVICO G. GORDONCILLO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, MARICHU CADAA DUFFEE, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of CASH INVOICE duly issued by RITZ PIZZERIA,

Iñigo St., Obrero St., Davao City;

That the aforesaid CASH INVOICE have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of December 2015, at Davao City, Philippines
th

MARICHU CADAA DUFFEE

Affiant
TIN Number:949-130-628-000

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ARTEMIO B. PANDAMON, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Eastwest Bank, Sales Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of December 2015, at Davao City, Philippines
th

ARTEMIO B. PANDAMON
Affiant
Competent Proof of 655-00
9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, REX JASPER AGBON ARES, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of TRANSCRIPT OF RECORD (TOR) duly issued

to University of Mindanao, Davao City;

That the aforesaid TRANSCRIPT OF RECORD (TOR) have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
17th day of December 2015, at Davao City, Philippines

REX JASPER AGBON ARES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOHN PHILIP GOMEZ ABUELA, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City and PHILHEALTH ID duly issued by Philhealth,
Davao City and MERCURY POINT CARD duly issued by Mercury, Davao
City and COMPANY ID duly issued by Agency Prime Manpower and
AUTOMATED TELLER MACHINE (ATM) CARD duly issued by Security
Bank, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID,

PHILHEALTH ID, MERCURY POINT CARD, COMPANY ID and
AUTOMATED TELLER MACHINE (ATM) CARD have been inadvertently
lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of December 2015, at Davao City, Philippines
th

JOHN PHILIP GOMEZ ABUELA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 14th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EDNA MANAYAGA ENTAL, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PRIVATE SECURITY LICENSE CARD WITH

ID NO. R1120150401568 duly issued by Pnp Civil Security Group,
Manila;

That the aforesaid PRIVATE SECURITY LICENSE CARD WITH ID

NO. R1120150401568 have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of December 2015, at Davao City, Philippines
th

EDNA MANAYAGA ENTAL

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 14th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ANALIZA S. UNGGUI, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD WITH ACCOUNT NO. 100658062820 duly issued by Unionbank,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

WITH ACCOUNT NO. 100658062820 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14th day of December 2015, at Davao City, Philippines

ANALIZA S. UNGGUI
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 14th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ERLINDA T. DAYATAN, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT have been

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of December 2015, at Davao City, Philippines
th

ERLINDA T. DAYATAN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 14th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOELITO C. BACATIO, of legal age, Filipino and a resident of

Manay, Davao Oriental, after having been duly sworn to in accordance
with the law, do hereby depose and say:
That I am a holder of PURCHASE ORDER w/ NO.118828 duly
issued by LTS Cityfoods Inc., Davao City;

That the aforesaid PURCHASE ORDER w/ NO.118828 have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of December 2015, at Davao City, Philippines
th

JOELITO C. BACATIO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JUSTINO BUGSAD JR., of legal age, Filipino and a resident of

Manay, Davao Oriental, after having been duly sworn to in accordance
with the law, do hereby depose and say:

That I am a holder of PAWNPAPER WITH RECEIPT NO. 0959-

2015-00896 duly issued by Mlhuillier, Manay, Davao Oriental;

That the aforesaid PAWNPAPER WITH RECEIPT NO. 0959-2015-

00896 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11th day of December 2015, at Davao City, Philippines

JUSTINO BUGSAD JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NELSON D. PELAYO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am an authorize representative of KLG INTERNATIONAL,

INC. who is holder of CHECK w/ CHECK NO. 0431741943 dated
NOVEMBER 14, 2015 amounting to Php.19,699.53 w/ O.R. NO.
0583 duly issued by Republic Biscuit Corporation, Alae, Manolo, Fortich,
Bukidnon;

That the aforesaid CHECK NO. 0431741943 dated NOVEMBER

14, 2015 amounting to Php.19,699.53 w/ O.R. NO. 0583 have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
11 day of December 2015, at Davao City, Philippines
th

NELSON D. PELAYO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NELSON D. PELAYO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am an authorize representative of KLG INTERNATIONAL,

INC. who is holder of COUNTER RECEIPT WITH INVOICE NO. 0886
DATED 10/03/15 WITH THE AMOUNT OF PHP16,378-00, INVOICE
NO. 0887 DATED 10/03/15 WITH THE AMOUNT OF PHP17,750.40,
INVOICE NO. 0888 DATED 10/03/15 WITH THE AMOUNT OF
PHP18,192.60, INVOICE NO. 0890 DATED 10/03/15 WITH THE
AMOUNT OF PHP17,690.04, INVOICE NO. 0891 DATED 10/03/15
WITH THE AMOUNT OF PHP7,482.00 duly issued by Vjandep
Bakeshop, Cagayan De Oro;

That the aforesaid COUNTER RECEIPT WITH INVOICE NO. 0886

DATED 10/03/15 WITH THE AMOUNT OF PHP16,378-00, INVOICE
NO. 0887 DATED 10/03/15 WITH THE AMOUNT OF PHP17,750.40,
INVOICE NO. 0888 DATED 10/03/15 WITH THE AMOUNT OF
PHP18,192.60, INVOICE NO. 0890 DATED 10/03/15 WITH THE
AMOUNT OF PHP17,690.04, INVOICE NO. 0891 DATED 10/03/15
WITH THE AMOUNT OF PHP7,482.00 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of December 2015, at Davao City, Philippines
th

NELSON D. PELAYO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, NELSON D. PELAYO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am an authorize representative of KLG INTERNATIONAL,

INC. who is holder of COUNTER RECEIPT WITH INVOICE NO. 288717
DATED 11/06/13 WITH THE AMOUNT OF PHP62,838.00, INVOICE
NO. 336252 DATED 03/04/15 WITH THE AMOUNT OF
PHP83,784.00, INVOICE NO. 0717 DATED 08/13/15 WITH THE
AMOUNT OF PHP28,773.00 duly issued by Gaisano, Cagayan De Oro;

That the aforesaid COUNTER RECEIPT WITH INVOICE NO.

288717 DATED 11/06/13 WITH THE AMOUNT OF PHP62,838.00,
INVOICE NO. 336252 DATED 03/04/15 WITH THE AMOUNT OF
PHP83,784.00, INVOICE NO. 0717 DATED 08/13/15 WITH THE
AMOUNT OF PHP28,773.00 have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of December 2015, at Davao City, Philippines
th

NELSON D. PELAYO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NELSON D. PELAYO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am an authorize representative of KLG INTERNATIONAL,

INC. who is holder of CHECK w/ CHECK NO. 0000417591 dated
NOVEMBER 14, 2015 amounting to Php.99,290.56 w/ O.R. NO.
0582 duly issued by SFI Fresh Bakers Corporation, Alae, Manolo, Fortich,
Bukidnon;

That the aforesaid CHECK w/ CHECK NO. 0000417591 dated

NOVEMBER 14, 2015 amounting to Php.99,290.56 w/ O.R. NO.
0582 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11th day of December 2015, at Davao City, Philippines

NELSON D. PELAYO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NELSON D. PELAYO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am an authorize representative of KLG INTERNATIONAL,
INC. of CHECK w/ CHECK NO. 0000417591 dated NOVEMBER 14,
2015 amounting to Php.99,290.56 w/ O.R. NO. 0582 duly issued by
Asia United Bank (AUB), Davao City;

That the aforesaid CHECK w/ CHECK NO. 0000417591 dated

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of December 2015, at Davao City, Philippines
th

NELSON D. PELAYO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JOSEPHINE BROILLET, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER WITH PT #50403SG011633

PRINCIPAL AMOUNT PHP10,500, LOAN DATE NOVEMBER 12, 2015,
EXPIRY DATE MARCH 13, 2016, MATURITY DATE DECEMBER 14,
2015, DESCRIPTION NECKLACE duly issued by Cebuana Lhuillier,
Davao City;

That the aforesaid PAWNPAPER WITH PT #50403SG011633

PRINCIPAL AMOUNT PHP10,500, LOAN DATE NOVEMBER 12, 2015,
EXPIRY DATE MARCH 13, 2016, MATURITY DATE DECEMBER 14,
2015, DESCRIPTION NECKLACE have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

JOSEPHINE BROILLET
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSEPHINE BROILLET, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER WITH PT #50420SG014004,

MATURITY DATE 12-7-2015, LOAN DATE 11-5-2015 and EXPIRY
DATE 3-7-2015 WITH PRINCIPAL AMOUNT OF PHP5, 260.00, ITEM
DESCRIPTION PENDANT W/HEART DESIGN duly issued by Cebuana
Lhuillier, Davao City;

That the aforesaid PAWNPAPER WITH PT #50420SG014004,

MATURITY DATE 12-7-2015, LOAN DATE 11-5-2015 and EXPIRY
DATE 3-7-2015 WITH PRINCIPAL AMOUNT OF PHP5, 260.00, ITEM
DESCRIPTION PENDANT W/HEART DESIGN have been inadvertently
lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

JOSEPHINE BROILLET
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JAYSEL LAZAGA VILLAMIL, of legal age, Filipino and a resident
of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11th day of December 2015, at Davao City, Philippines

JAYSEL LAZAGA VILLAMIL

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, MAURICE JAY SARAZA VILLARMENTE, of legal age, Filipino and

a resident of Davao City, after having been duly sworn to in accordance
with the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Asia United Bank (AUB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of December 2015, at Davao City, Philippines
th

MAURICE JAY SARAZA VILLARMENTE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, QUINCY NORMAN DABAO QUIMSING, of legal age, Filipino and

a resident of Davao City, after having been duly sworn to in accordance
with the law, do hereby depose and say:

That I am a holder of UMID CARD WITH CRN 006001212781

WITH BANK ACCOUNT NO. 109567258166 duly issued by Government
Social Insurance System (GSIS), Davao City;

That the aforesaid UMID CARD WITH CRN 006001212781 WITH

BANK ACCOUNT NO. 109567258166 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of December 2015, at Davao City, Philippines
th
QUINCY NORMAN DABAO QUIMSING
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, IVY KIM D. MACHICA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am the authorized representative/sister of RUDYARD KIP D.

DACUMOS a holder of ELEMENTARY DIPLOMA duly issued by F.
Bustamante Central Elementary School, Davao City;
That the aforesaid ELEMENTARY DIPLOMA have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of December 2015, at Davao City, Philippines
th

IVY KIM D. MACHICA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, EDA THERESE C. ABELITA, of legal age, Filipino and a resident
of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by University of Southeastern Philippines (USEP), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of December 2015, at Davao City, Philippines

EDA THERESE C. ABELITA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, DENVER N. ROSIL, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Robinson’s Bank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of December 2015, at Davao City, Philippines

DENVER N. ROSIL
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10th day of December
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CIRILO GENOLOS MAASIN, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Chinabank, Buhangin Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of December 2015, at Davao City, Philippines
CIRILO GENOLOS MAASIN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARK R. GUIBONE., of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am the authorized representative of MCKENZIE DISTRIBUTION

CO., INC. a holder of ORIGINAL SALES INVOICE WITH INVOICE NO.
M000937648 WITH THE AMOUNT OF PHP1, 801.00 DELIVERY DATE
11/23/15 duly issued to Puregold, Davao City;
That the aforesaid ORIGINAL SALES INVOICE WITH INVOICE NO.
M000937648 WITH THE AMOUNT OF PHP1, 801.00 DELIVERY DATE
11/23/15 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of December 2015, at Davao City, Philippines

MARK R. GUIBONE
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, CARLO D. CANO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of December 2015, at Davao City, Philippines

CARLO D. CANO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ROGIE IAN V. MAGBANUA, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER duly issued by Rosever

Pawnshop, Agdao Branch, Davao City;

That the aforesaid PAWNPAPER have been inadvertently lost and

despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of December 2015, at Davao City, Philippines

ROGIE IAN V. MAGBANUA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, OFELIA SANCHEZ BANIQUED, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of OFFICIAL RECEIPT OF AUTHENTICATION

CERTIFICATE WITH O.R #0384 duly issued by Department of Foreign
Affairs (DFA), Manila;

That the aforesaid OFFICIAL RECEIPT OF AUTHENTICATION

CERTIFICATE WITH O.R #0384 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of December 2015, at Davao City, Philippines

OFELIA SANCHEZ BANIQUED

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALVIN PISALBON LINSAG, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am a holder of PHILIPPINE NATIONAL POLICE (PNP) ID
AND ECG RECEIPT duly issued by PNP, Davao City;

That the aforesaid PHILIPPINE NATIONAL POLICE (PNP) ID AND

ECG RECEIPT have been inadvertently lost and despite of diligent efforts
to locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of December 2015, at Davao City, Philippines

ALVIN PISALBON LINSAG

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, CARISSA H. BANGA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of HEALTH CARD duly issued by City Health

Office (CHO), Davao City;

That the aforesaid HEALTH CARD have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of December 2015, at Davao City, Philippines

CARISSA H. BANGA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, CHINLEE S. TABORDA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of TRANSCRIPT OF RECORD (T.O.R.) duly

issued by University of Mindanao, Bolton branch, Davao City;

That the aforesaid TRANSCRIPT OF RECORD (T.O.R.) have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of December 2015, at Davao City, Philippines
CHINLEE S. TABORDA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ERNESTO SABADO DURAN, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of December 2015, at Davao City, Philippines

ERNESTO SABADO DURAN

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NOEME PATAC SEGARRA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am a holder of AUTOMATED TELLER MACHINE (ATM)
CARD duly issued by Unionbank, U.N Ave. Branch, Ermita Manila;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of December 2015, at Davao City, Philippines

NOEME PATAC SEGARRA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ROLAND M. POSTRANO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of December 2015, at Davao City, Philippines

ROLAND M. POSTRANO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 8th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, GLORIMEL COMPOC CALVEZ, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT WITH PASSPORT

NO. EC2344913 duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT WITH PASSPORT NO.

EC2344913 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines
GLORIMEL COMPOC CALVEZ
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CRISEL DELOS REYES BUHAWE, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of POLICY CONTRACT WITH POLICY NO. 510-

3221346 duly issued by AXA Philippines, Davao City;

That the aforesaid POLICY CONTRACT WITH POLICY NO. 510-

3221346 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

CRISEL DELOS REYES BUHAWE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARIA MILAGROSA C. ENOFRE, of legal age, Filipino and a
resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am the authorized representative of PRYCE PROPERTIES

CORP. who is a holder of OFFICIAL RECEIPT OF TRANFER TAX WITH
OR NO. 5882372 duly issued by City Assessors Office, Davao City;

That the aforesaid OFFICIAL RECEIPT OF TRANFER TAX WITH

OR NO. 5882372 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

MARIA MILAGROSA[[] C. ENOFRE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, VANESSA R. ADAM, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Robinson’s Bank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

VANESSA R. ADAM
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JANSEN COLINA PALICTE, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines
JANSEN COLINA PALICTE
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSEPHINE BROILLET, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER WITH PT #50420SG014004

duly issued by Cebuana Lhuillier, Davao City;
That the aforesaid PAWNPAPER WITH PT #50420SG014004
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

JOSEPHINE BROILLET
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JOSEPHINE BROILLET, of legal age, Filipino and a resident of
Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER WITH PT #50403SG011633

duly issued by Cebuana Lhuillier, Davao City;

That the aforesaid PAWNPAPER WITH PT #50403SG011633

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

JOSEPHINE BROILLET
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JOSEPHINE BROILLET, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PAWNPAPER WITH PT #60467SG007341

duly issued by Cebuana Lhuillier, Davao City;

That the aforesaid PAWNPAPER WITH PT #60467SG007341

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

JOSEPHINE BROILLET
Affiant

Competent Proof of 655-00

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA MILAGROSO C. ESOPRE, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am the authorized representative of PRYCE PROPERTIES

CORP. who is a holder of OFFICIAL RECEIPT OF TRANFER TAX WITH
OR NO. 5882372 duly issued by City Assessors Office, Davao City;

That the aforesaid OFFICIAL RECEIPT OF TRANFER TAX WITH

OR NO. 5882372 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th
day of December 2015, at Davao City, Philippines

MARIA MILAGROSO C. ESOPRE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, HECTOR FLORES PANES, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am the father of HECKLEY T. PANES who is the holder of

SCHOOL IDENTIFICATION CARD duly issued by Ateneo de Davao
University (Junior High School), Matina, Davao City;
That the aforesaid SCHOOL IDENTIFICATION CARD have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

HECTOR FLORES PANES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, BENJAMIN BERNABE, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

BENJAMIN BERNABE
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, MERVIN BARREDO FUENTES, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am the authorized representative of TERRY THOMAS

BARREDO MCMAHON a holder of HIGH SCHOOL DIPLOMA duly issued
by Emar Academy learning Center, Davao City;

That the aforesaid HIGH SCHOOL DIPLOMA have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

MERVIN BARREDO FUENTES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA LEONORA C. MARGEN, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th
day of December 2015, at Davao City, Philippines

MARIA LEONORA C. MARGEN

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CLARO LECIAS MURCIA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB), Davao City;
That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of December 2015, at Davao City, Philippines

CLARO LECIAS MURCIA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 7th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARIO F. TEVES, of legal age, Filipino and a resident of Davao
City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City, and SENIOR CITIZENS ID duly
issue by OSCA, Davao City and SOCIAL SECURITY SYSTEM (SSS) ID
duly issued by SSS, Davao City;

That the aforesaid DRIVER’S LICENSE, SENIOR CITIZENS ID and

SOCIAL SECURITY SYSTEM (SSS) ID have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2015, at Davao City, Philippines

MARIO F. TEVES
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, KATHERINE LONGAKIT BALLESTA, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AMOSUP IDENTIFICATION CARD (ID) WITH

ID NO. 182883 duly issued by Amosup Seaman’s Hospital, Davao City,
Philippines;

That the aforesaid AMOSUP IDENTIFICATION CARD (ID) WITH

ID NO. 182883 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2015, at Davao City, Philippines

KATHERINE LONGAKIT BALLESTA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DOMINADOR VIRAY BALLESTA III, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of OFFICIAL RECEIPT (OR) OF

CONSTRUCTION BOND duly issued by 8990 Housing Development
Corporation, Davao City, Philippines;

That the aforesaid OFFICIAL RECEIPT (OR) OF CONSTRUCTION

BOND have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th
day of December 2015, at Davao City, Philippines

DOMINADOR VIRAY BALLESTA III

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DOMINADOR VIRAY BALLESTA III, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AMOSUP IDENTIFICATION CARD (ID) WITH

ID NO. 182882 duly issued by Amosup Seaman’s Hospital, Manila,
Philippines;
That the aforesaid AMOSUP IDENTIFICATION CARD (ID) WITH
ID NO. 182882 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2015, at Davao City, Philippines

DOMINADOR VIRAY BALLESTA III

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, JELLOU RAY MACAYAN, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD WITH ACCOUNT NO. 10-141-8235540 duly issued by
Unionbank, Magsaysay Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

WITH ACCOUNT NO. 10-141-8235540 have been inadvertently lost
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2015, at Davao City, Philippines

JELLOU RAY MACAYAN

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, BERNARDITA SAMSON MANTE, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of ST, PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. ___________________ AND ST. PETER IDENTIFICATION
CARD (ID) duly issued by St. Peter Life Plan, Inc., Davao City;

That the aforesaid ST, PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. ___________________ AND ST. PETER IDENTIFICATION
CARD (ID) have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2015, at Davao City, Philippines

BERNARDITA SAMSON MANTE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CONSTANCIA C. ALBINA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Unionbank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th
day of December 2015, at Davao City, Philippines

CONSTANCIA C. ALBINA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOHN WALTER SARUCAM JUAREZ, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by RCBC, Davao City;
That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2015, at Davao City, Philippines

JOHN WALTER SARUCAM JUAREZ

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4th day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, BRAULIO MUTIA TORMIS, of legal age, Filipino and a resident of
Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SENIOR CITIZENS IDENTIFICATION CARD

(ID) duly issued by OSCA, Davao City;

That the aforesaid SENIOR CITIZENS IDENTIFICATION CARD (ID)

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2015, at Davao City, Philippines

BRAULIO MUTIA TORMIS

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, NESTOR BATALUNA AGUILAN JR., of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Landbank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2015, at Davao City, Philippines

NESTOR BATALUNA AGUILAN JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EARL KIN L. FRANCO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2015, at Davao City, Philippines
EARL KIN L. FRANCO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RENMARIE ZAMBRANO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Unionbank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st
day of December 2015, at Davao City, Philippines

RENMARIE ZAMBRANO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ESTRELLA O. GABINES, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am a holder of PRC ID, SSS ID, LANDBANK ATM CARD,
BPI ATM CARD, METROBANK ATM CARD, PLDT SIM CARD,
CITIBANK CREDIT CARD, BPI CREDIT CARD, BPI CHECK (blank) duly
issued by government and non-government agencies, Davao City;

That the aforesaid PRC ID, SSS ID, LANDBANK ATM CARD, BPI
ATM CARD, METROBANK ATM CARD, PLDT SIM CARD, CITIBANK
CREDIT CARD, BPI CREDIT CARD, BPI CHECK (blank) have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2015, at Davao City, Philippines

ESTRELLA O. GABINES
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, NOEL ALOG SAJONIA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2015, at Davao City, Philippines

NOEL ALOG SAJONIA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, HANNAH LENN SADIO LISING, of legal age, Filipino and a

resident of Cotabato City, after having been duly sworn to in accordance
with the law, do hereby depose and say:

That I am a holder of PRC ID CLAIM STUB duly issued by

Professional Regulation Commission (PRC), Davao City;

That the aforesaid PRC ID CLAIM STUB have been inadvertently

lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2015, at Davao City, Philippines

HANNAH LENN SADIO LISING

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 1st day of December
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROEL D. GASLANG, of legal age, Filipino and a resident of Km 5

Guadalupe Village Matina Crossing, Davao City, after having been duly
sworn to in accordance with the law, do hereby depose and say:

That I am a holder of a Identification described as follows;

TIN CARD duly issued by the Bureau Internal Revenue (BIR)

SSS Identification Card issued by the Social Security System
ATM duly issued by the East west Bank
Cash Card issued by the Banco de Oro
Drivers License issued by the Land Transportation Office (LTO)

That the aforesaid Identification Card (ID) have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
27th day of November 2015, at Davao City, Philippines

ROEL D. GASLANG
Affiant
tent Proof of 655-00
9404-5
SUBSCRIBED AND SWORN to before me this 27th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MICHELLE GUILARAN FARNAZO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of CERTIFICATE OF AUTHORIZING

REGISTRATION (CAR) WITH CAR NO. 176444 duly issued by Bureau of
Internal Revenue (BIR), Davao City;
That the aforesaid CERTIFICATE OF AUTHORIZING
REGISTRATION (CAR) WITH CAR NO. 176444 have been inadvertently
lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

27th day of November 2015, at Davao City, Philippines

MICHELLE GUILARAN FARNAZO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 27th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ISIDRO V. ALBANO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of TIN CARD WITH TIN NO. 102-664-549-000

duly issued by Bureau of Internal Revenue (BIR), Davao City;

That the aforesaid TIN CARD WITH TIN NO. 102-664-549-000

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26TH day of November 2015, at Davao City, Philippines

ISIDRO V. ALBANO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, LILIAN A. OLALO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by One Network Bank (ONB), Tibungco Branch Davao
City and Landbank, Bajada Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 TH
day of November 2015, at Davao City, Philippines

LILIAN A. OLALO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NOEMI ABAWAN BERGHOFER, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of TIN CARD WITH TIN NO. 268683474 duly

issued by Bureau of Internal Revenue (BIR), Davao City;

That the aforesaid TIN CARD WITH TIN NO. 268683474 have
been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 TH
day of November 2015, at Davao City, Philippines
NOEMI ABAWAN BERGHOFER
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RICHILLE MAY ALAMBATIN FULGUERINAS, of legal age,

Filipino and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Asia United Bank (AUB), Bajada Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 TH
day of November 2015, at Davao City, Philippines

RICHILLE MAY ALAMBATIN FULGUERINAS

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MICHELLE ROSE FEROLIN FERNANDEZ, of legal age, Filipino

and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:
That I am a holder of T.O.P. duly issued by Land Transportation
Office (LTO), Davao City;

That the aforesaid T.O.P. have been inadvertently lost and despite
of diligent efforts to locating and recovering it, the same could no longer
be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26TH day of November 2015, at Davao City, Philippines

MICHELLE ROSE FEROLIN FERNANDEZ

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NIEL PAGARAN ARCAYNA, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City and HEALTH CARD duly issued by City Health
Office, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID and

HEALTH CARD have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 TH
day of November 2015, at Davao City, Philippines

NIEL PAGARAN ARCAYNA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JOHN PAUL C. DUMASIG, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of ATOMATED TELLER MACHINE CARD (ATM)

duly issued by Security Bank, Monteverde branch, Davao City;

That the aforesaid ATOMATED TELLER MACHINE CARD (ATM)

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

25th day of November 2015, at Davao City, Philippines

JOHN PAUL C. DUMASIG

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 25th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KATHANTI CHANDRA BABU, of legal age, Indian and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PASSPORT WITH PASSPORT NO.

M1069121 duly issued by Indian Embassy;

That the aforesaid PASSPORT WITH PASSPORT NO. M1069121

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
24 day of November 2015, at Davao City, Philippines
th

KATHANTI CHANDRA BABU

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 24th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RUBYLYN B. EGAGAMAO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of OFFICIAL RECEIPT OF AUTHENTICATION

CERTIFICATE w/ no. 0023 dated August 27, 2014 duly issued by
Department of Foreign Affairs (DFA), Manila, Philippines;
That the aforesaid OFFICIAL RECEIPT OF AUTHENTICATION
CERTIFICATE w/ no. 0023 dated August 27, 2014 have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24th day of November 2015, at Davao City, Philippines

RUBYLYN B. EGAGAMAO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 24th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, VIRCRES L. OBELIDHON, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PASSBOOK duly issued by MEMBA

Association, Davao City;

That the aforesaid PASSBOOK have been inadvertently lost and

despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24th day of November 2015, at Davao City, Philippines

VIRCRES L. OBELIDHON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 24th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ROWEL C. CLAUD, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Banco De Oro, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24th day of November 2015, at Davao City, Philippines

ROWEL C. CLAUD
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 24th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MANUEL SILVA NADA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City, Philippines;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of November 2015, at Davao City, Philippines
th
MANUEL SILVA NADA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 24th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA SALOME P. SALOMON, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. 96439965 duly issued by St. Peter Life Plan, Inc., Davao
City, Philippines;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. 96439965 have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of November 2015, at Davao City, Philippines

MARIA SALOME P. SALOMON

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GLORY GRACE DURA TUYOR, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:
That I am a holder of OFFICIAL RECEIPT (O.R) WITH O.R NO.
49309218 MONTH OF MARCH 2014 duly issued by Philhealth, Davao
City, Philippines;

That the aforesaid OFFICIAL RECEIPT (O.R) WITH O.R NO.

49309218 MONTH OF MARCH 2014 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of November 2015, at Davao City, Philippines
rd

GLORY GRACE DURA TUYOR

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JOSE A. ALBALADEJO, of legal age, married, Filipino, a resident

of Purok San Nicolas, Manggahan St., Buhangin, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a ST. PETER LIFE PLAN POLICY with

Policy No. L12307597P duly issued by the St. Peter Life Plan, Inc.;

That the aforesaid ST. PETER LIFE PLAN POLICY has been
inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of October 2014 at Davao City, Philippines

JOSE A. ALBALADEJO
Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0010-0030123-2

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, VILMA MERCADO ROXAS, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB), Davao City,
Philippines;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of November 2015, at Davao City, Philippines
VILMA MERCADO ROXAS
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JAY S. ALBARRACIN, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by University of Southeastern Philippines (USEP), Davao City,
Philippines;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20TH day of November 2015, at Davao City, Philippines

JAY S. ALBARRACIN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 20TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARLOS B. BAUTISTA SR., of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH
CONTRACT NO. L12198341D duly issued by St. Peter Life Plan, Inc.,
Davao City, Philippines;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. L12198341D have been inadvertently lost and despite
of diligent efforts to locating and recovering it, the same could no longer
be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20TH
day of November 2015, at Davao City, Philippines

CARLOS B. BAUTISTA SR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 20TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, POTENCIANO GO NASSER JR., of legal age, Filipino and a

resident of Santo Tomas, Davao Del Norte, after having been duly sworn
to in accordance with the law, do hereby depose and say:

That I am a holder of PROFESSIONAL REGULATION

COMMISSION (PRC) ID WITH ID NO. 0034977 duly issued by PRC,
Davao City, Philippines;

That the aforesaid PROFESSIONAL REGULATION COMMISSION

(PRC) ID WITH ID NO. 0034977 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 TH
day of November 2015, at Davao City, Philippines

POTENCIANO GO NASSER JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 20TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DELIA N. PESTILOS, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of IDENTIFICATION CARD duly issued by PAG-

IBIG FUNDS, Bureau of Internal Revenue (BIR), Philippines;

That the aforesaid IDENTIFICATION CARD have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of November 2015, at Davao City, Philippines
th

DELIA N. PESTILOS
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 19th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LUCITA C. AMPER, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of CANCELLED CHECK w/ account no.853052,

853057, 853062 duly issued by Land Bank of the Philippines, Davao City,
Philippines;

That the aforesaid CANCELLED CHECK w/ account no.853052,

853057, 853062 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of November 2015, at Davao City, Philippines
th

LUCITA C. AMPER
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 19th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EDGARDO P. SORONGON, of legal age, Filipino and a resident of

Skyline, Catalunan Grande, Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:
That I am a holder of BLUE COPY OF CERTIFICATE OF
AUTHORIZING REGISTRATION (CAR) and FORM 1706 with RECEIPT
duly issued by Bureau of Internal Revenue (BIR), Davao City, Philippines;

That the aforesaid DUPLICATE OF CERTIFICATE OF

AUTHORIZING REGISTRATION (CAR) and FORM 1706 with RECEIPT
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of November 2015, at Davao City, Philippines

EDGARDO P. SORONGON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 19th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JESSE GEM J. CAÑON, of legal age, Filipino and a resident of

Block 05 Lot 13 Emelia Homes Subd.,Cabantian, Buhangin, Davao City,
after having been duly sworn to in accordance with the law, do hereby
depose and say:

That I am a holder of OFFICIAL RECEIPT of AUTHENTICATION

CERTIFICATE w/ no.0076 dated October 07, 2015 duly issued by
Department of Foreign Affairs (DFA), Manila, Philippines;

That the aforesaid OFFICIAL RECEIPT of AUTHENTICATION

CERTIFICATE w/ no.0076 dated October 07, 2015 have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of November 2015, at Davao City, Philippines

JESSE GEM J. CAÑON

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 19th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, MARLYN SOLOMON ANGHAD, of legal age, Filipino and a

resident of Salavacion, Monkayo, Comval Province, after having been duly
sworn to in accordance with the law, do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT WITH PASSPORT

NO. EB9277323 duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT WITH PASSPORT NO.

EB9277323 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of November 2015, at Davao City, Philippines
th

MARLYN SOLOMON ANGHAD

Affiant
Competent Proof of 655-00
9404-5
SUBSCRIBED AND SWORN to before me this 19th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA T. PAUSAL, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by and One Network Bank, Bankerohan Branch, Davao
City and PHILHEALTH IDENTIFICATION CARD (ID) duly issued by
PHILHEALTH, Davao City and AMOSUP IDENTIFICATION CARD (ID),
Amosup, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD,

PHILHEALTH IDENTIFICATION CARD (ID) and AMOSUP
IDENTIFICATION CARD (ID) have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18 TH
day of November 2015, at Davao City, Philippines

MARIA T. PAUSAL
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 18TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LIZ U. GOLIDTUM, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:
That I am a holder of HONARABLE DISMISSAL duly issued by
University of Immaculate Conception (UIC), Bangkerohan branch, Davao
City;

That the aforesaid HONARABLE DISMISSAL have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18TH day of November 2015, at Davao City, Philippines

LIZ U. GOLIDTUM
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 18TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARIA FLOR C. DE VENANCIO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of MEDFORD Rx SOLUTION ID, BPI ATM

CARD, BDO ATM CARD, LENOVO TABLET, LENOVO ANDROID
PHONE, SMART BROADBAND, COSMETICS /GOODS, HMI HEALTH
CARD duly issued by government and non-government agencies;

That the aforesaid MEDFORD Rx SOLUTION ID, BPI ATM CARD,

BDO ATM CARD, LENOVO TABLET, LENOVO ANDROID PHONE,
SMART BROADBAND, COSMETICS /GOODS, HMI HEALTH CARD have
been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18TH
day of November 2015, at Davao City, Philippines

MARIA FLOR C. DE VENANCIO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 18TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA FLOR C. DE VENANCIO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of ACER LAPTOP, SAMSUNG CELLPHONE and

METROBANK ATM CARD duly issued by Medford Rx Solution, Inc.,
Quezon City;

That the aforesaid ACER LAPTOP, SAMSUNG CELLPHONE and

METROBANK ATM CARD have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18TH day of November 2015, at Davao City, Philippines

MARIA FLOR C. DE VENANCIO

Affiant
Competent Proof of 655-00
9404-5
SUBSCRIBED AND SWORN to before me this 18TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA FLOR C. DE VENANCIO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT WITH PASSPORT

NO. EB3310756 duly issued by Department of Foreign Affairs (DFA),
Davao City;

That the aforesaid PHILIPPINE PASSPORT WITH PASSPORT NO.

EB3310756 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
18 TH
day of November 2015, at Davao City, Philippines

MARIA FLOR C. DE VENANCIO

Affiant

Competent Proof of 655-00

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA FLOR C. DE VENANCIO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT WITH PASSPORT

NO. EB3310756 duly issued by Department of Foreign Affairs (DFA),
Davao City;
That the aforesaid PHILIPPINE PASSPORT WITH PASSPORT NO.
EB3310756 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18 TH
day of November 2015, at Davao City, Philippines

MARIA FLOR C. DE VENANCIO

Affiant

Competent Proof of 655-00

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARIA FLOR C. DE VENANCIO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PROFESSIONAL REGULATION

COMMISSION (PRC) ID WITH ID NO. 0029124 duly issued by PRC,
Manila;

That the aforesaid PROFESSIONAL REGULATION COMMISSION

(PRC) ID WITH ID NO. 0029124 have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18TH day of November 2015, at Davao City, Philippines

MARIA FLOR C. DE VENANCIO

Affiant

Competent Proof of 655-00

AFFIDAVIT OF LOSS

I, CHRISTIAN MANATAD, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of HEALTH CARD duly issued by City Health

Office, Davao City;

That the aforesaid HEALTH CARD have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18TH day of November 2015, at Davao City, Philippines

CHRISTIAN MANATAD
Affiant

Competent Proof of 655-00

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DELIA CAJEGAS ATCHERO, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SAVINGS PASSBOOK WITH ACCOUNT NO.

065-51-039171 duly issued by One Network Bank (ONB), Sasa Branch,
Davao City;

That the aforesaid SAVINGS PASSBOOK WITH ACCOUNT NO.

065-51-039171 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of November 2015, at Davao City, Philippines
th
DELIA CAJEGAS ATCHERO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 17th day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALBARAH SARANDA MEDITAR, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of IDENTIFICATION CARD (ID) duly issued by

Professional Regulation Commission (PRC), Davao City;

That the aforesaid IDENTIFICATION CARD (ID) have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of November 2015, at Davao City, Philippines

ALBARAH SARANDA MEDITAR

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 16th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

epublic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GILBERT LUAÑA BACARO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of ATOMATED TELLER MACHINE CARD

NO.4404-5288-2940-3819 (ATM) w/ account no. 101180082025
duly issued by Union Bank, Magsaysay branch, Davao City;

That the aforesaid ATOMATED TELLER MACHINE CARD

NO.4404-5288-2940-3819 (ATM) w/ account no. 101180082025
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of November 2015, at Davao City, Philippines

GILBERT LUAÑA BACARO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 16th day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PATRICK ANGELO OLAYVAR LOCEO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of CERTIFICATE OF REGISTRATION duly issued

by Bureau of Internal Revenue (BIR), Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of November 2015, at Davao City, Philippines

PATRICK ANGELO OLAYVAR LOCEO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 16th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ALDRIN S. BUHIAN, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by University of Southeastern Philippines (USEP), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of November 2015, at Davao City, Philippines
th

ALDRIN S. BUHIAN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 16th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, NORMEL MALITOC MAPANSA, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PNB ATM CARD, LANDBANK CASH CARD,

PHILHEALTH ID, NCCC REWARD CARD and VOTER’S ID duly issued
by government and non-government agencies, Davao City;

That the aforesaid PNB ATM CARD, LANDBANK CASH CARD,

PHILHEALTH ID, NCCC REWARD CARD and VOTER’S ID have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of November 2015, at Davao City, Philippines

NORMEL MALITOC MAPANSA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 16th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEONARDO M. SAMBALOD JR., of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of UMID CARD, DRIVER’S LICENSE,

PHILHEALTH ID, POSTAL ID, VOTER’S ID and RECEIPT duly issued by
government and non-government agencies, Davao City;

That the aforesaid UMID CARD, DRIVER’S LICENSE,

PHILHEALTH ID, POSTAL ID, VOTER’S ID and RECEIPT have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of November 2015, at Davao City, Philippines

LEONARDO M. SAMBALOD JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 16th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FROILAN I. CASTILLO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of OFFICIAL RECEIPT #57593A with stated

amount of PHP.18,113.24 dated June 27, 2015 duly issued by
University of Mindanao (UM), Matina branch, Davao City;

That the aforesaid OFFICIAL RECEIPT #57593A with stated

amount of PHP.18,113.24 dated June 27, 2015 have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13th day of November 2015, at Davao City, Philippines

FROILAN I. CASTILLO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ELLYN R. TONGAN, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of PASSBOOK duly issued by Metro Bank,

Ecoland branch, Davao City;

That the aforesaid PASSBOOK have been inadvertently lost and

despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13 day of November 2015, at Davao City, Philippines
th

ELLYN R. TONGAN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY CLAUDITH B. MOMO, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Assumption College of Davao, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13 day of November 2015, at Davao City, Philippines
th
MARY CLAUDITH B. MOMO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SUNDAY L. CORTEZ, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of ATOMATED TELLER MACHINE CARD (ATM)

duly issued by One Network Bank, Calinan branch, Davao City;

That the aforesaid ATOMATED TELLER MACHINE CARD (ATM)

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
13 day of November 2015, at Davao City, Philippines
th

SUNDAY L. CORTEZ
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ILYN ROSE GABUDAO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PINOY COOP ATM IDENTIFICATION CARD

(ID) duly issued by Tagum Multi-Purpose Cooperative, Bajada Branch,
Davao City;
That the aforesaid PINOY COOP ATM IDENTIFICATION CARD
(ID) have been inadvertently lost and despite of diligent efforts to locating
and recovering it, the same could no longer be found, hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13th day of November 2015, at Davao City, Philippines

ILYN ROSE GABUDAO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, KRIZA JANE PANSOY GUMAHAD, of legal age, Filipino and a
resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Unionbank, Victoria Plaza Mall Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13th day of November 2015, at Davao City, Philippines

KRIZA JANE PANSOY GUMAHAD

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 13th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

We, J. SALEM C. LAGAT and JOFERN R. COLETO, of legal age,

Filipino and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:

That we are holder of PASSBOOK w/ account no. 008093-0193-

94 duly issued by Bank of the Philippine Island (BPI), Abreeza branch,
Davao City;

That the aforesaid PASSBOOK w/ account no. 008093-0193-94

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, We consider it
lost;

That we are executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 TH
day of November 2015, at Davao City, Philippines

J. SALEM C. LAGAT JOFERN R.

COLETO
Affiant Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALICE LATURZA BUCA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of GREEN CARD (ID) duly issued by Los

Angeles, California;

That the aforesaid GREEN CARD (ID) have been inadvertently lost
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12TH day of November 2015, at Davao City, Philippines

ALICE LATURZA BUCA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 12TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, REX LOPEZ CAÑETE, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SSS ID, DRIVER`S LICENSE, CENTRAL 911

ID and LANDBANK ATM duly issued by government and non
government agencies, Davao City;

That the aforesaid SSS ID, DRIVER`S LICENSE, CENTRAL 911 ID

and LANDBANK ATM have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11TH day of November 2015, at Davao City, Philippines

REX LOPEZ CAÑETE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KARLO JAN D. MAGBOJOS, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Unionbank, Victoria Plaza Mall Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11TH day of November 2015, at Davao City, Philippines

KARLO JAN D. MAGBOJOS

Affiant
Competent Proof of 655-00
9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ESTHER MAJOR SRIDHER SILVESTER, of legal age, Indian and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of FOOD PASS duly issued by DMEMS

Management, DMSF, Davao City;

That the aforesaid FOOD PASS have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 TH
day of November 2015, at Davao City, Philippines
ESTHER MAJOR SRIDHER SILVESTER
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALICIA B. PANZO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11TH day of November 2015, at Davao City, Philippines

ALICIA B. PANZO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARITES BON PLACA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT WITH PASSPORT

NO. JJ182754 duly issued by Department of Foreign Affairs (DFA), Davao
City;
That the aforesaid PHILIPPINE PASSPORT WITH PASSPORT NO.
JJ182754 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11TH day of November 2015, at Davao City, Philippines

MARITES BON PLACA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JOCELYN L. IBAÑEZ, of legal age, Filipino and a resident of
Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of CASH CARD duly issued by 4PS, Davao City;

That the aforesaid CASH CARD have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 TH
day of November 2015, at Davao City, Philippines

JOCELYN L. IBAÑEZ
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, JOCELYN L. IBAÑEZ, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of CASH CARD duly issued by 4PS, Davao City;

That the aforesaid CASH CARD have been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 TH
day of November 2015, at Davao City, Philippines

JOCELYN L. IBAÑEZ
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LAARNI GALVEZ SECJADAS of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of TIN CARD, PHILHEALTH ID, PRC LICENSE

ID, TEACHER’S ID, GSIS ID, SSS ID, LANDBANK ATM CARD,
BARANGAY ID, VOTER’S ID duly issued by government and non-
government agencies;

That the aforesaid TIN CARD, PHILHEALTH ID, PRC ID,

TEACHER’S ID, GSIS ID, SSS ID, LANDBANK ATM CARD, BARANGAY
ID, VOTER’S ID have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 TH
day of November 2015, at Davao City, Philippines

LAARNI GALVEZ SECJADAS

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 11TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RONILO M. SANTA CRUZ of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of CHECK WITH CHECK NO. 2385095 AND

NO. 2385217 duly issued by Landbank, Davao City;

That the aforesaid CHECK WITH CHECK NO. 2385095 AND NO.
2385217 have been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 TH
day of November 2015, at Davao City, Philippines

RONILO M. SANTA CRUZ

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NISHANTHI PRABAKAR of legal age, Indian and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Davao Medical School Foundation (DMSF), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) have

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 TH
day of November 2015, at Davao City, Philippines

NISHANTHI PRABAKAR
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROSARIO BENTOY CORTEZ of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of OFFICIAL RECEIPT (OR) DATED JULY 2011

UP TO MARCH 2015 duly issued by PHILHEALTH, Davao City;

That the aforesaid OFFICIAL RECEIPT (OR) DATED JULY 2011 UP

TO MARCH 2015 have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10TH day of November 2015, at Davao City, Philippines
ROSARIO BENTOY CORTEZ
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOHN FILINO RAMOS CANENCIA of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Banco De Oro (BDO);

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
10TH day of November 2015, at Davao City, Philippines

JOHN FILINO RAMOS CANENCIA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ELMER MARQUEZ MAMBURAN of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE have been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10TH day of November 2015, at Davao City, Philippines

ELMER MARQUEZ MAMBURAN

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 10TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SHIRWENA R. LATRAS of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID,

PHILHEALTH ID, TIN CARD, HEALTH CARD, PAG-IBIG ID;
That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID,
PHILHEALTH ID, TIN CARD, HEALTH CARD, PAG-IBIG ID has been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of October 2015, at Davao City, Philippines

SHIRWENA R. LATRAS
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ROFEL T. MANILA of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of PHILHEALTH IDENTIFICATION CARD (ID)

duly issued by PHILHEALTH, Davao City;

That the aforesaid PHILHEALTH IDENTIFICATION CARD (ID) has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of November 2015, at Davao City, Philippines

ROFEL T. MANILA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEONERA VALENCIA MONTECILLO of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of November 2015, at Davao City, Philippines

LEONERA VALENCIA MONTECILLO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CONCEPTION T. VERONA of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PASSBOOK w/ account no. 10850004724

duly issued by Maybank, Lanang branch, Davao City;

That the aforesaid PASSBOOK w/ account no. 10850004724 has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of November 2015, at Davao City, Philippines
CONCEPTION T. VERONA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EVELYN A. AYUPAN of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of IDENTIFICATION CARD (ID) duly issued by

Philippine Regulation Commission (PRC) and Office of the Senior Citizen
Association (OSCA) here in Davao City;
That the aforesaid IDENTIFICATION CARD (ID) has been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of November 2015, at Davao City, Philippines

EVELYN A. AYUPAN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARIE ANN KAYE M. PARAJES of legal age, Filipino and a
resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB);

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of October 2015, at Davao City, Philippines

MARIE ANN KAYE M. PARAJES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SHIRWENA R. LATRAS of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID,

PHILHEALTH ID, TIN CARD, HEALTH CARD, PAG-IBIG ID;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID,

PHILHEALTH ID, TIN CARD, HEALTH CARD, PAG-IBIG ID has been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 TH

day of October 2015, at Davao City, Philippines

SHIRWENA R. LATRAS
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROSS CARLO D. SARMAGO of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Davao Merchant Marine Academy (DMMA), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

09 day of November 2015, at Davao City, Philippines
th
ROSS CARLO D. SARMAGO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 09th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SHERLIE H. ABREGANA of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am the authorized representative/sister of RHEA JOY H.

ABREGANA a holder of COMPANY IDENTIFICATION CARD (ID) duly
issued by Davao Doctors Hospital, Davao City;
That the aforesaid COMPANY IDENTIFICATION CARD (ID) has
been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

09th day of November 2015, at Davao City, Philippines

SHERLIE H. ABREGANA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 09th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, KATHERINE B. ALBARILLO of legal age, Filipino and a resident
of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of ATOMATED TELLER MACHINE CARD (ATM)

duly issued by Philippine National Bank (PNB), Claveria branch, Davao
City;

That the aforesaid ATOMATED TELLER MACHINE CARD (ATM)

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

09th day of November 2015, at Davao City, Philippines

KATHERINE B. ALBARILLO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 09th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GRACE ANN A. BARIBAR of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID with

SSS NO. 0924258734 duly issued by SSS, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID with

SSS NO. 0924258734 have been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of November 2015, at Davao City, Philippines

GRACE ANN A. BARIBAR

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 9th day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOANA JEAN JUMANGITO of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Holy Cross of Davao College (HCDC), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of November 2015, at Davao City, Philippines
JOANA JEAN JUMANGITO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALRENZ JAY R. BELLO of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of PURCHASE ORDER w/ no.

duly issued by LTS Community Stores, Davao City;
That the aforesaid PURCHASE ORDER w/ no.
has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of November 2015, at Davao City, Philippines

ALRENZ JAY R. BELLO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, RAISALAM DACUA DIMAAYAO of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of SAVINGS PASSBOOK with ACCOUNT NO.

004-05-05862-9 duly issued by Al-Amanah Islamic Investment Bank
(094), Davao City;

That the aforesaid SAVINGS PASSBOOK with ACCOUNT NO.

004-05-05862-9 has been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of November 2015, at Davao City, Philippines

RAISALAM DACUA DIMAAYAO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAFFY JAY L. CORONADO of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of GOOD MORAL, HIGH SCHOOL DIPLOMA

AND HIGH SCHOOL CARD duly issued by Davao City National High
School, Davao City;

That the aforesaid GOOD MORAL, HIGH SCHOOL DIPLOMA AND

HIGH SCHOOL CARD have been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of November 2015, at Davao City, Philippines

RAFFY JAY L. CORONADO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 6th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MYZA RAE CAÑON CABOVERDE of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of HIGH SCHOOL DIPLOMA duly issued by Holy

Cross of Mintal, Davao City;

That the aforesaid HIGH SCHOOL DIPLOMA have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th
day of November 2015, at Davao City, Philippines

MYZA RAE CAÑON CABOVERDE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 5th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RICHELLE GRACE MARAVILLES JAUDINES of legal age, Filipino

and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:

That I am the authorized representative of MARKETREACH

DISTRIBUTORS, INC. a holder of COUNTER RECEIPT WITH NO. 31480-
01 DATED JULY 23, 2015 WITH A TOTAL AMOUNT OF PHP17,
884.85 duly issued by Gaisano Grand-Tagum, Tagum City;

That the aforesaid COUNTER RECEIPT WITH NO. 31480-01

DATED JULY 23, 2015 WITH A TOTAL AMOUNT OF PHP17, 884.85
have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of November 2015, at Davao City, Philippines

RICHELLE GRACE MARAVILLES JAUDINES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 5th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, JAMES FROILAND G. CATINDIG of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of COLLEGE DIPLOMA duly issued by San Pedro

College (SPC), Davao City;

That the aforesaid COLLEGE DIPLOMA have been inadvertently

lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of November 2015, at Davao City, Philippines

JAMES FROILAND G. CATINDIG

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 5th day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RANDOLPH OLIVER O. VILLEGAS of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of CERTIFICATE OF COMPLETION duly issued

by DMMA College of Southern Philippines, Davao City;

That the aforesaid CERTIFICATE OF COMPLETION have been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

RANDOLPH OLIVER O. VILLEGAS

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JULIE AMOR BARA of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City and TIN CARD duly issued by Bureau of
Internal Revenue (BIR), Davao City and PHILHEALTH IDENTIFICATION
CARD (ID) duly issued by PHILHEALTH, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID, TIN

CARD and PHILHEALTH IDENTIFICATION CARD (ID) have been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH
day of November 2015, at Davao City, Philippines

JULIE AMOR BARA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FLORENTINO T. BAYOT JR. of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of ATOMATED TELLER MACHINE CARD (ATM)

duly issued by Union Bank, Monteverde branch, Davao City;
That the aforesaid ATOMATED TELLER MACHINE CARD (ATM)
have been inadvertently lost last October 21, 2015 and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

FLORENTINO T. BAYOT JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

FLORENTRepublic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARICRIS CATACUTAN LATURGO of legal age, Filipino and a
resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am the authorized representative of METRO DRUG, INC. a

holder of SALES INVOICE WITH INVOICE NO. 1001079388 duly issued
to Gama Foods Corp., Baloy, Tablon, Cagayan De Oro City;

That the aforesaid SALES INVOICE WITH INVOICE NO.

1001079388 have been inadvertently lost last October 27, 2015 and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

MARICRIS CATACUTAN LATURGO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ASNAIRA SULTAN BADIO of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Holy Cross of Davao College (HCDC), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) have

been inadvertently lost last October 27, 2015 and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

ASNAIRA SULTAN BADIO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SIONG-WEE, CHIN of legal age, Malaysian National and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of SIMCARD WITH SIM NO. 09491999888

duly issued by Smart Company, Davao City;

That the aforesaid SIMCARD WITH SIM NO. 09491999888 have

been inadvertently lost last October 27, 2015 and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines
SIONG-WEE, CHIN
Affiant
PASSPORT NO. A31949896

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SIONG-WEE, CHIN of legal age, Malaysian National and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of SIMCARD WITH SIM NO. 09151302939

duly issued by Globe Telecommunication, Davao City;

That the aforesaid SIMCARD WITH SIM NO. 09151302939 have

been inadvertently lost last October 27, 2015 and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

SIONG-WEE, CHIN
Affiant
PASSPORT NO. A31949896

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JESSAR L. MATEO of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:
That I am the authorized representative of DC INVEST, INC. a
holder of CHARGE SALES INVOICE WITH NO. 200795 duly issued to
WVP Lopsons, Bangoy St., Davao City;

That the aforesaid CHARGE SALES INVOICE WITH NO. 200795

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

JESSAR L. MATEO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, JESSAR L. MATEO of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am the authorized representative of DC INVEST, INC. a

holder of CHARGE SALES INVOICE WITH NO. 200824 duly issued to
Save-O-Matic, Toril, Davao City;

That the aforesaid CHARGE SALES INVOICE WITH NO. 200824

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

JESSAR L. MATEO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JESSAR L. MATEO of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am the authorized representative of DC INVEST, INC. a

holder of CHARGE SALES INVOICE WITH NO. 200829 duly issued to
Grocers Mart, Toril, Davao City;

That the aforesaid CHARGE SALES INVOICE WITH NO. 200829

have been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH

day of November 2015, at Davao City, Philippines

JESSAR L. MATEO
Affiant

Competent Proof of 655-00

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JESSAR L. MATEO of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am the authorized representative of DC INVEST, INC. a

holder of CHARGE SALES INVOICE WITH NO. 200794 duly issued to
Lots 4 Less, Lanang, Davao City;

That the aforesaid CHARGE SALES INVOICE WITH NO. 200794

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 TH
day of November 2015, at Davao City, Philippines

JESSAR L. MATEO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 4TH day of November
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARICHU NONONG CADAA of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of CERTIFICATE OF REGISTRATION (COR)

duly issued by Bureau of Internal Revenue (BIR), Davao City;
That the aforesaid CERTIFICATE OF REGISTRATION (COR) has
been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th

MARICHU NONONG CADAA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, RUBY JEAN DABON of legal age, Filipino and a resident of Davao
City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of TIN CARD duly issued by Bureau of Internal

Revenue (BIR), Davao City and SOCIAL SECURITY SYSTEM (SSS) ID
duly issued by SSS, Davao City and DRIVER’S LICENSE duly issued by
Land Transportation Office (LTO), Davao City;

That the aforesaid TIN CARD, SOCIAL SECURITY SYSTEM (SSS)

ID and DRIVER’S LICENSE has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30th day of October 2015, at Davao City, Philippines

RUBY JEAN DABON

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SHIRWENA R. LATRAS of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID,

PHILHEALTH ID, TIN CARD, HEALTH CARD, PAG-IBIG ID;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID,

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th

SHIRWENA R. LATRAS
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CRISANTO JAMERO PILAPIL, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th
CRISANTO JAMERO PILAPIL
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALEX ROY N. ALIA, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by BPI, Lanang Branch, Davao City and HEALTH CARD
duly issued by City Health Office, Davao City;
That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD
and HEALTH CARD has been inadvertently lost and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30th day of October 2015, at Davao City, Philippines

ALEX ROY N. ALIA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, DULCE C. CABANA, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am the authorized representative/brother of APOLLO IAN C.

DAVID a holder of SCHOOL IDENTIFICATION CARD (ID) duly issued by
Ateneo De Davao University, Roxas Campus, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th

MICHAEL PAUL C. DAVID

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MAILA CASTROMAYOR REYES, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder PHILHEALTH IDENTIFICATION CARD (ID) duly

issued by PHILHEALTH, Davao City;

That the aforesaid PHILHEALTH IDENTIFICATION CARD (ID) has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30th day of October 2015, at Davao City, Philippines

MAILA CASTROMAYOR REYES

Affiant

Competent Proof of 655-00

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DAVE HIBAYA, of legal age, Filipino and a resident of Davao City,

after having been duly sworn to in accordance with the law, do hereby
depose and say:

That I am a holder COMPANY IDENTIFICATION CARD (ID) duly

issued by NCCC MALL, Davao City and HEALTH CARD duly issued by City
Health Office, Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD (ID) and

HEALTH CARD has been inadvertently lost and despite of diligent efforts
to locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th
DAVE HIBAYA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, BERNARD V. CACANINDIN, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder PAWNPAPER WITH PT # 263842 AND WITH

CONTROL NO. 318822 duly issued by Davao Ros-ver Pawnshop, Inc.,
Bankerohan Branch, Davao City;
That the aforesaid PAWNPAPER WITH PT # 263842 AND WITH
CONTROL NO. 318822 has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th

BERNARD V. CACANINDIN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 30th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ROWENA V. CHIO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder BUSINESS PLATE WITH BUSINESS ID NO.

2001-155829 duly issued by Business Bureau, Davao City;

That the aforesaid BUSINESS PLATE WITH BUSINESS ID NO.

2001-155829 has been inadvertently lost and despite of diligent efforts
to locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2015, at Davao City, Philippines
th

ROWENA V. CHIO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, AURORA V. CHIO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder BUSINESS PLATE WITH BUSINESS ID NO.

2001-141156 and BUSINESS ID NO. 1999-175846 duly issued by
Business Bureau, Davao City;

That the aforesaid BUSINESS PLATE WITH BUSINESS ID NO.

2001-141156 and BUSINESS ID NO. 1999-175846 has been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30th day of October 2015, at Davao City, Philippines

AURORA V. CHIO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JENIFER M. SINGAYEN, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City and PHILHEALTH ID, duly issued by
PHILHEALTH, Davao City and AUTOMATED TELLER MACHINE (ATM)
CARD duly issued by Landbank, San Pedro Branch, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID,

PHILHEALTH ID and AUTOMATED TELLER MACHINE (ATM) CARD
has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
29th day of October 2015, at Davao City, Philippines

JENIFER M. SINGAYEN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARK JAY BENITEZ, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder ATOMATED TELLER MACHINE CARD (ATM),

PHIL.HEALTH CARD, HEALTH CARD, NBI CLEARANCE, STUDENT
PERMIT duly issued by Local, Private and Government Agencies here in
Davao City;

That the aforesaid ATOMATED TELLER MACHINE CARD (ATM),

PHIL.HEALTH CARD, HEALTH CARD, NBI CLEARANCE, STUDENT
PERMIT has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of October 2015, at Davao City, Philippines
th

MARK JAY BENITEZ

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LYSTERH BEE JAY V. FUENTES, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder ATTENDANCE CARD, duly issued by University

of Mindanao (UM), Davao City;

That the aforesaid ATTENDANCE CARD has been inadvertently lost

and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29th day of October 2015, at Davao City, Philippines

LYSTERH BEE JAY V. FUENTES

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EMERITO L. PURISIMA, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder AUTOMATED TELLER MACHINE CARD (ATM),

IDENTIFICATION CARD (ID), CREDIT CARD, duly issued by Bank of the
Philippine Island (BPI), Philippine National Bank (PNB), Metrobank and Post
Office;

That the aforesaid AUTOMATED TELLER MACHINE CARD (ATM),

IDENTIFICATION CARD (ID), CREDIT CARD has been inadvertently lost
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29th day of October 2015, at Davao City, Philippines

EMERITO L. PURISIMA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CRISTINA MEDIANO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder PAWN PAPER with control no. 74840 with

stated (1) UNIT OF GRINDER (MAKITA BRAND) dated July 30, 2015
duly issued by PAG-ASA PAWNSHOP, Davao City;

That the aforesaid PAWN PAPER with control no. 74840 with
stated (1) UNIT OF GRINDER (MAKITA BRAND) dated July 30, 2015
has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
29 day of October 2015, at Davao City, Philippines
th

CRISTINA MEDIANO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PAUL JETHRO C. BALUYOT, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder AUTOMATED TELLER MACHINE CARD (ATM)

duly issued by Metrobank, Bajada branch, Davao City;
That the aforesaid AUTOMATED TELLER MACHINE CARD (ATM)
has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29th day of October 2015, at Davao City, Philippines

PAUL JETHRO C. BALUYOT

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, LEOLINDO L. SAYSON, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder CERTIFICATE OF PAYMENT AND POLICY

CONTRACT with account no. 77-71-38-01-H0152 CFP no. EK-03-
000737-4 and 60-71-38-01-A01096 CPF no. EK-04-000187-8 duly
issued by College Assurance Plan Phils. Inc., Davao City;

That the aforesaid CERTIFICATE OF PAYMENT AND POLICY

CONTRACT with account no. 77-71-38-01-H0152 CFP no. EK-03-
000737-4 and 60-71-38-01-A01096 CPF no. EK-04-000187-8 has
been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of October 2015, at Davao City, Philippines
th

LEOLINDO L. SAYSON
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 29th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARILYN R. ALMASAN, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. L12120400D duly issued by St. Peter Life Plan, Inc.,
Davao City;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. L12120400D has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

27 day of October 2015, at Davao City, Philippines
th

MARILYN R. ALMASAN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 27th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GLADWIN G. ALBARAN, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder HONARABLE DISMISSAL, TRANSCRIPT OF

RECORD AND GOOD MORAL duly issued by INTERFACE College of
Davao, Davao City;

That the aforesaid HONARABLE DISMISSAL, TRANSCRIPT OF

RECORD AND GOOD MORAL has been inadvertently lost and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
26th day of October 2015, at Davao City, Philippines

GLADWIN G. ALBARAN
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DARWIN S. ASOTEGUE, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder TEMPORARY DRIVER’S LICENSE duly issued

by Land Transportation Office (LTO), Davao City;
That the aforesaid TEMPORARY DRIVER’S LICENSE has been
inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of October 2015, at Davao City, Philippines
th

DARWIN S. ASOTEGUE
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, JEOVANNY MOLERO ALFORQUE JR., of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder AUTOMATED TELLER MACHINE (ATM) CARD

duly issued by Bank of Commerce, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of October 2015, at Davao City, Philippines
th

JEOVANNY MOLERO ALFORQUE JR.

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, BERNARD TAPIZ LAGON, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder SIMCARD WITH SIM NO. 09984941680 duly

issued by Smart Prepaid, Davao City;

That the aforesaid SIMCARD WITH SIM NO. 09984941680 has

been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of October 2015, at Davao City, Philippines
th

BERNARD TAPIZ LAGON

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 26th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ADRIANA P. NANTES, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder CLAIM STUB OF PRC ID duly issued by PRC,

Davao City;

That the aforesaid CLAIM STUB OF PRC ID has been inadvertently

lost and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of October 2015, at Davao City, Philippines
ADRIANA P. NANTES
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DONAH JOY M. BUJAUE, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder SCHOOL IDENTIFICATION CARD (ID) duly

issued by Holy Cross of Davao College (HCDC), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of October 2015, at Davao City, Philippines

DONAH JOY M. BUJAUE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARK ANTHONY PARAN MALUENDA, of legal age, Filipino and

a resident of Davao City, after having been duly sworn to in accordance
with the law, do hereby depose and say:
That I am a holder HONORABLE DISMISSAL and NATIONAL
CERTIFICATE (IV) (IT PROGRAMMING) duly issued by University of
Mindanao (UM), Toril branch and TESDA, Davao City;

That the aforesaid HONORABLE DISMISSAL and NATIONAL

CERTIFICATE (IV) (IT PROGRAMMING) has been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of October 2015, at Davao City, Philippines

MARK ANTHONY PARAN MALUENDA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MANUELITO DUMADAG GALLEGO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder IDENTIFICATION CARD (ID) (TIN) w/ no. 439

109 900 000 duly issued by Bureau of Internal Revenue (BIR) , Davao
City;

That the aforesaid IDENTIFICATION CARD (ID) (TIN) w/ no. 439

109 900 000 has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of October 2015, at Davao City, Philippines
rd

MANUELITO DUMADAG GALLEGO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MANUELITO DUMADAG GALLEGO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder IDENTIFICATION CARD (ID) (TIN) w/ no. 439

109 900 000 duly issued by Bureau of Internal Revenue (BIR) , Davao
City;

That the aforesaid IDENTIFICATION CARD (ID) (TIN) w/ no. 439

109 900 000 has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of October 2015, at Davao City, Philippines
rd
MANUELITO DUMADAG GALLEGO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JIMMY BAUTISTA COMAYAS, of legal age, Filipino and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder OFFICIAL RECEIPT OF DRIVER’S LICENSE

duly issued by Land Transportation Office (LTO), Davao City;

That the aforesaid OFFICIAL RECEIPT OF DRIVER’S LICENSE has

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of October 2015, at Davao City, Philippines
rd

JIMMY BAUTISTA COMAYAS

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 23rd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARISA S. POTENTE, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:
That I am the mother of LOWELL S. POTENTE, 15 years old;

That my son is a holder SCHOOL IDENTIFICATION CARD (ID) duly

issued by Daniel R. Aguinaldo National High School, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of October 2015, at Davao City, Philippines

MARISA S. POTENTE
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOCEL ALEGADO VALMONTE, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder HIGH SCHOOL DIPLOMA duly issued by F.

Bangoy National High School, Sasa, Davao City;

That the aforesaid HIGH SCHOOL DIPLOMA has been

inadvertently lost and despite of diligent efforts to locating and recovering
it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of October 2015, at Davao City, Philippines

JOCEL ALEGADO VALMONTE

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, REY GELIG CABALLERO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder T.O.P. WITH APPREHENSIVE DATE JANUARY

29, 2015 duly issued by Land Transportation Office (LTO), Davao City;

That the aforesaid T.O.P. WITH APPREHENSIVE DATE JANUARY

29, 2015 has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of October 2015, at Davao City, Philippines

REY GELIG CABALLERO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JENNELYN C. LUBIANO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Gabriel Taborin College of Davao and COMPANY
IDENTIFICATION CARD (ID) duly issued by GMALL of Davao and
PHILHEALTH IDENTIFICATION CARD (ID) duly issued by PHILHEALTH,
Davao City and AUTOMATED TELLER MACHINE (ATM) CARD duly
issued by Banco De Oro, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID),

COMPANY IDENTIFICATION CARD (ID), PHILHEALTH
IDENTIFICATION CARD (ID), AUTOMATED TELLER MACHINE (ATM)
CARD has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
22 nd
day of October 2015, at Davao City, Philippines

JENNELYN C. LUBIANO
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SHOMESH BASKAR KUMAR, of legal age, Indian and a resident

of Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by RCBC, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of October 2015, at Davao City, Philippines

SHOMESH BASKAR KUMAR

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PRINCESS VENNES E. LINGAYAO, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:
That I am a holder of AUTOMATED TELLER MACHINE (ATM)
CARD duly issued by RCBC, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of October 2015, at Davao City, Philippines

PRINCESS VENNES E. LINGAYAO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, NOIME DUPLA DINGGO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of TIN CARD WITH TIN NO. 434-866-968-000

duly issued by Bureau of Internal Revenue (BIR), Davao City;

That the aforesaid TIN CARD WITH TIN NO. 434-866-968-000

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of October 2015, at Davao City, Philippines

NOIME DUPLA DINGGO

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 22nd day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, BETTY M. ORBETA, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Asia United Bank (AUB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21st day of October 2015, at Davao City, Philippines

BETTY M. ORBETA
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JEREBE JUNE TOLENTINO SUMALINOG, of legal age, Filipino

and a resident of Davao City, after having been duly sworn to in
accordance with the law, do hereby depose and say:

That I am a holder of SAMSUNG J1 PLAN duly issued by Globe

Telecommunication, Davao City;

That the aforesaid SAMSUNG J1 PLAN has been inadvertently lost

last October 17, 2015 and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21 day of October 2015, at Davao City, Philippines
st
JEREBE JUNE TOLENTINO SUMALINOG
Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KENDALL NEIL CAGO BASA, of legal age, Filipino and a resident

of NHA Ma-a, Davao City, after having been duly sworn to in accordance
with the law, do hereby depose and say:

That I am a student of CHRISTIAN COLLEGES OF SOUTHEAST

ASIA;

That the CHRISTIAN COLLEGES OF SOUTHEAST ASIA located at

Ma-a, Davao City issued a FORM 137-A / REPORT CARD last 2013;

That the aforesaid FORM 137-A / REPORT CARD has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
21 day of October 2015, at Davao City, Philippines
st

KENDALL NEIL CAGO BASA

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIA TERESA ABARCA CABAHUG, of legal age, Filipino and a

resident of Davao City, after having been duly sworn to in accordance with
the law, do hereby depose and say:

That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. _____________________ duly issued by St. Peter Life Plan,
Inc., Davao City;
That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH
CONTRACT NO. _____________________ has been inadvertently lost or
missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21 day of October 2015, at Davao City, Philippines
st

MARIA TERESA ABARCA CABAHUG

Affiant

Competent Proof of 655-00

9404-5
SUBSCRIBED AND SWORN to before me this 21st day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, RAMIL DALAGAN YABO, of legal age, Filipino and a resident of

Davao City, after having been duly sworn to in accordance with the law,
do hereby depose and say:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Metrobank, Roxas Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21 day of October 2015, at Davao City, Philippines
st

RAMIL DALAGAN YABO

Affiant

Competent Proof of 655-000

No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 21st day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JULIET C. PEJANO, of legal age, Filipino and a resident of Davao

City, after having been duly sworn to in accordance with the law, do
hereby depose and say:

That I am the authorized representative/sister of JOJIE C. PEJANO

who is the owner of certain business located at121 Phase 1 Blk 4, New
Matina, Davao City;

That my sister is a holder of CERTIFICATE OF REGISTRATION

(COR) duly issued by Bureau of Internal Revenue (BIR), Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION (COR) has

been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 TH
day of October 2015, at Davao City, Philippines

JULIET C. PEJANO
Affiant

Competent Proof of 655-000

No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ANGELICA S. ROYO, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
20TH day of October 2015, at Davao City, Philippines

ANGELICA S. ROYO
Affiant

Competent Proof of Identity:

TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JO AN BASMAYOR BARBON, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;
That the aforesaid PHILIPPINE PASSPORT has been inadvertently
lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 TH
day of October 2015, at Davao City, Philippines

JO AN BASMAYOR BARBON
Affiant

Competent Proof of Identity:

TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

We, ELMAR BERONA NERI and FLORDELITA A. NERI, of legal

ages, Filipinos, and a resident of Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That we are a holder of PASSBOOK duly issued by Philippine

National Bank (PNB), Davao City;

That the aforesaid PASSBOOK has been inadvertently lost

sometimes last October 16, 2015 when we are travelling to Mati City, we
noticed that the passbook inside the shoulder bag was missing and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That we are executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19TH day of October 2015, at Davao City, Philippines

ELMAR BERONA NERI FLORDELITA A. NERI

Affiant Affiant

Competent Proof of Identity:

TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 19TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, VILMA T. ATILLO, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19TH day of October 2015, at Davao City, Philippines

VILMA T. ATILLO
Affiant

Competent Proof of Identity:

TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 19TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DEMI CHARITY PATRICE A. PALANCA, of legal age, Filipino, and

a resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of OFFICIAL RECEIPT (OR) duly issued by Gmall

of Davao, Bajada, Davao City;

That the aforesaid OFFICIAL RECEIPT (OR) has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
19 TH
day of October 2015, at Davao City, Philippines

DEMI CHARITY PATRICE A. PALANCA

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 19TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ELENA MIRAMBEL SILANGAN, of legal age, Filipino, and a

resident of Poblacion, Arakan, Cotabato, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am a holder of VOTER’S IDENTIFICATION CARD (ID) duly

issued by COMELEC, Arakan, Cotabato;
That the aforesaid VOTER’S IDENTIFICATION CARD (ID) has
been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of October 2015, at Davao City, Philippines

ELENA MIRAMBEL SILANGAN

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 16th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, EDITH T. OCAMPOS, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of IDENTIFICATION CARD (ID) duly issued by

Social Security System (SSS), Bajada, Davao City;

That the aforesaid IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of October 2015, at Davao City, Philippines

EDITH T. OCAMPOS
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 16th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DOUGHTTY JOY C. IBAÑEZ, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of (2) TWO AUTOMATED TELLER MACHINE

(ATM), COMPANY IDENTIFICATION CARD (ID) duly issued by
Development Bank of the Philippines (DBP), Bank of Philippine Islands
(BPI), Southern Philippines Medical Center (SPMC), Davao City;

That the aforesaid (2) TWO AUTOMATED TELLER MACHINE

(ATM), COMPANY IDENTIFICATION CARD (ID) has been inadvertently
lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of October 2015, at Davao City, Philippines
th

DOUGHTTY JOY C. IBAÑEZ

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 16th day of October
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JULIUS RECENTES JIMENEZ, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM) duly

issued by Philippine National Bank (PNB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) has

been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
16 day of October 2015, at Davao City, Philippines
th

JULIUS RECENTES JIMENEZ

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 16th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ZITA M. ABDON, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am the authorized representative Brgy. Sec. ROLANDO P.

MUYCO JR. and Kagawad ARIEL A. AXALAN of Brgy. 26-C, Davao City
That I am a holder and the person stated above is a holder of
TERMINAL FEE (200 each person) with the total amount of Php
600.00 dated August 31, 2015 duly issued by Cebu Pacific, Davao City;

That the aforesaid TERMINAL FEE (200 each person) with the
total amount of Php 600.00 dated August 31, 2015 has been
inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of October 2015, at Davao City, Philippines
th

ZITA M. ABDON
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 16th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, LORNA TENEBROSO TABA, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the authorized representative of QUICK’O MANPOWER

SERVICES located at J.P Laurel Ave., Davao City

That the company is a holder of PHILHEALTH ORIGINAL RECEIPT

(OR) WITH OR #52474327 IN THE MONTH OF MAY 2014,
OR#48267871 IN THE MONTH OF JANUARY 2014 and OR
#50964732 IN THE MONTH OF APRIL 2014 duly issued by
PHILHEALTH, Davao City;

That the aforesaid PHILHEALTH ORIGINAL RECEIPT (OR) WITH

OR #52474327 IN THE MONTH OF MAY 2014, OR#48267871 IN
THE MONTH OF JANUARY 2014 and OR #50964732 IN THE MONTH
OF APRIL 2014 has been inadvertently lost or missing and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

15 day of October 2015, at Davao City, Philippines
th

LORNA TENEBROSO TABA

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 15th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KEMLIE FAITH I. LEGARIO, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by University of Mindanao (UM), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

15 day of October 2015, at Davao City, Philippines
th
KEMLIE FAITH I. LEGARIO
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 15th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ADRIAN SARDA, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Davao Merchant Marine Academy, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
15th day of October 2015, at Davao City, Philippines

ADRIAN SARDA
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 15th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NAURYN VLENN VELASCO ENRIQUEZ, of legal age, Filipino,

and a resident of Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:
That I am a holder of TIN CARD duly issued by Bureau of Internal
Revenue (BIR), Davao City;

That the aforesaid TIN CARD has been inadvertently lost or missing
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of October 2015, at Davao City, Philippines
th

NAURYN VLENN VELASCO ENRIQUEZ

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ROSA MAE SAB FERNANDEZ, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of VOTER`S IDENTIFICATION CARD duly

issued by Comelec, Davao City;

That the aforesaid VOTER`S IDENTIFICATION CARD has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

15th day of October 2015, at Davao City, Philippines

ROSA MAE SAB FERNANDEZ

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 15th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SHIELA MAE B. ARTIAGA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PAWNPAPER duly issued by

____________________________, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost or

missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

15th day of October 2015, at Davao City, Philippines

SHIELA MAE B. ARTIAGA

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 15th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FLORENCE BALMORI REYES, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by University of Mindanao (UM), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

15 day of October 2015, at Davao City, Philippines
th

FLORENCE BALMORI REYES

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 15th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, HANSHILA VUDAGA, of legal age, Indian, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of FOOD PASS duly issued by San Pedro College

(SPC), Davao City;

That the aforesaid FOOD PASS has been inadvertently lost or

missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
14 day of October 2015, at Davao City, Philippines
th

HANSHILA VUDAGA
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RUGEBELLE GRACE ANGELES, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:
That I am a holder of PAWNPAPER WITH PT# 6023SG021536
and PT# 602315SG021535 duly issued by Cebuana Lhuillier, Davao
City;

That the aforesaid PAWNPAPER WITH PT# 6023SG021536 and

PT# 602315SG021535 has been inadvertently lost or missing and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of October 2015, at Davao City, Philippines
th

RUGEBELLE GRACE ANGELES

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, NAURYN VLENN VELASCO ENRIQUEZ, of legal age, Filipino,

and a resident of Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am a holder of FORM 1902 duly issued by Bureau of Internal

Revenue (BIR), Davao City;

That the aforesaid FORM 1902 has been inadvertently lost or

missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14th day of October 2015, at Davao City, Philippines

NAURYN VLENN VELASCO ENRIQUEZ

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JANNISA ORBETA LABOR, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14th day of October 2015, at Davao City, Philippines

JANNISA ORBETA LABOR

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NENITA L. ARCILLAS, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PAWNPAPER WITH PT#260428 duly issued

by Goldwin Pawnshop, Inc., Davao City;

That the aforesaid PAWNPAPER WITH PT#260428 has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of October 2015, at Davao City, Philippines
th

NENITA L. ARCILLAS
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MAE CLAVECILLAS ANTIOJO, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of PHILHEALTH OFFICIAL RECEIPT (OR) WITH

POR NO. 53241287 duly issued by PHILHEALTH, Davao City;

That the aforesaid PHILHEALTH OFFICIAL RECEIPT (OR) WITH

POR NO. 53241287 has been inadvertently lost or missing and despite
of diligent efforts to locating and recovering it, the same could no longer
be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
14 day of October 2015, at Davao City, Philippines
th

MAE CLAVECILLAS ANTIOJO

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PLANTILA P. MAGHARI, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the wife of the late ANTONIO MAGHARI SR. a registered

member of COCOLIFE INSURANCE, Davao City
That my husband a holder of COCOLIFE INSURANCE POLICY
WITH NO. PP 00083 duly issued by COCOLIFE INSURANCE, Davao City;

That the aforesaid COCOLIFE INSURANCE POLICY WITH NO. PP

00083 has been inadvertently lost or missing and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of October 2015, at Davao City, Philippines
th

PLANTILA P. MAGHARI
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 14th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, CECILIA RAYA PANGANORON, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Tagum Multi-Purpose Cooperative, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13 day of October 2015, at Davao City, Philippines
th

CECILIA RAYA PANGANORON

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 13th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ELENITA PLANDES ROBLE, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of SOCIAL SECURITY SYSTEM (SSS) ID duly

issued by SSS, Davao City;

That the aforesaid SOCIAL SECURITY SYSTEM (SSS) ID has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13th day of October 2015, at Davao City, Philippines

ELENITA PLANDES ROBLE

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 13th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARK ANTHONY C. LIZA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of VOTER`S IDENTIFICATION CARD (ID),

POSTAL IDENTIFICATION CARD (ID), PAFCIPIC IDENTIFICATION
CARD (ID) and PHILHEALTH ID;

That the aforesaid VOTER`S IDENTIFICATION CARD (ID),

POSTAL IDENTIFICATION CARD (ID), PAFCIPIC IDENTIFICATION
CARD (ID) and PHILHEALTH ID has been inadvertently lost or missing
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
13th day of October 2015, at Davao City, Philippines

MARK ANTHONY C. LIZA

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 13th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PRINCESS JASMIN HERRERO, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Holy Cross of Davao College (HCDC), Davao City;
That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been
inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 day of October 2015, at Davao City, Philippines
th

PRINCESS JASMIN HERRERO

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 12th day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, LENETTE G. CAMBALON, of legal age, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PAWNPAPER WITH PT #129672 duly issued

by Rosegold Pawnshop, San Pedro Branch, Davao City;

That the aforesaid PAWNPAPER WITH PT #129672 has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 day of October 2015, at Davao City, Philippines
th

LENETTE G. CAMBALON
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 12th day of October
2015, at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LYNDON JOHNSON SENG, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of DEBIT CARD duly issued by Union Bank, Rizal

branch, Davao City;

That the aforesaid DEBIT CARD has been inadvertently lost or

missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of October 2015, at Davao City, Philippines

LYNDON JOHNSON SENG

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 9th day of October 2015,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CESAR TRUYA JR., of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of BOARDING PASS Flight No. 5J 964 (Davao

to Manila) dated September 16, 2015 at the time of departure
10:15am, arrival at 12:00pm duly issued by Cebu Pacific Airlines,
Davao City;

That the aforesaid BOARDING PASS Flight No. 5J 964 (Davao to

Manila) dated September 16, 2015 at the time of departure
10:15am, arrival at 12:00pm has been inadvertently lost or missing
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of October 2015, at Davao City, Philippines

CESAR TRUYA JR.

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 9th day of October 2015,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEMUEL JOSEPH C. GEPIGON, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of IDENTIFICATION CARD (ID), ATOMATED

TELLER MACHINE CARD (ATM) AND STUDENT PERMIT duly issued by
XAVIER UNIVERSITY ATENEO DE CAGAYAN, MOSCAT, One Network bank
(ONB), Land Transportation Office (LTO), Davao City;

That the aforesaid IDENTIFICATION CARD (ID), ATOMATED

TELLER MACHINE CARD (ATM) AND STUDENT PERMIT has been
inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th
day of October 2015, at Davao City, Philippines

LEMUEL JOSEPH C. GEPIGON

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 9th day of October 2015,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALVIN M. CANDILADO, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of OFFICIAL RECEIPT of MOTOR VEHICLE w/

PLATE#LH-6484 duly issued by Land Transportation Office (LTO), Davao
City;

That the aforesaid OFFICIAL RECEIPT of MOTOR VEHICLE w/

PLATE#LH-6484 has been inadvertently lost or missing and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of October 2015, at Davao City, Philippines

ALVIN M. CANDILADO
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 9th day of October 2015,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, OLIVER LUAYON GARCIA, of legal age, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of COLLEGE DIPLOMA duly issued by Samson

Technical Institute, Davao City;

That the aforesaid COLLEGE DIPLOMA has been inadvertently lost

or missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of October 2015, at Davao City, Philippines

OLIVER LUAYON GARCIA

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 9th day of October 2015,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GERRY TAN GUINGUE, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of COLT REVOLVER, CAL. 38 WITH SERIAL

NUMBER 10937;

That the aforesaid COLT REVOLVER, CAL. 38 WITH SERIAL

NUMBER 10937 has been inadvertently lost or missing and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of October 2015, at Davao City, Philippines

GERRY TAN GUINGUE

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 8th day of October 2015,
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ELMAR BERONA NERI, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of ATOMATED TELLER MACHINE CARD (ATM)

duly issued by Land Bank of the Philippines, Claveria branch, Davao City;

That the aforesaid ATOMATED TELLER MACHINE CARD (ATM)

has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of October 2015, at Davao City, Philippines

ELMAR BERONA NERI

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 7th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NECITA AGUSTINO HERMOSO, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the grandmother of ANDREA RESTEL A. HERMOSO,

who is a minor;

That a holder of SCHOOL IDENTIFICATION CARD duly issued by

Davao City National High School, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of October 2015, at Davao City, Philippines
NECITA AGUSTINO HERMOSO
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 8th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARK JOHN G. UMBAC, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of OFFICIAL RECEIPT OF DRIVER’S LICENSE

duly issued by Land Transportation Office (LTO), Davao City;

That the aforesaid OFFICIAL RECEIPT OF DRIVER’S LICENSE has

been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of October 2015, at Davao City, Philippines

MARK JOHN G. UMBAC

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 7th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JELSY C. ALLARD, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of PROVISIONAL RECEIPT duly issued by

Caritas Health Shield, Inc., Davao City;

That the aforesaid PROVISIONAL RECEIPT has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of October 2015, at Davao City, Philippines

JELSY C. ALLARD
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 7th day of October 2015,
at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALEX GA-AS CADAY, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Banco De Oro (BDO), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of October 2015, at Davao City, Philippines
ALEX GA-AS CADAY
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 7th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, TERESITA R. RINGOR, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. ________________ duly issued by St. Peter Life Plan, Inc.,
Davao City;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. has been inadvertently lost or missing and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

TERESITA R. RINGOR
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, HAZEL FAITH S. ANUNCIADO, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of PHILIPPINE PASSPORT duly issued by

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

HAZEL FAITH S. ANUNCIADO

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ADONIS G. NOYNAY, of legal age, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. R07533455 AND CERTIFICATE OF FULL PAYMENT
duly issued by St. Peter Life Plan, Inc., Davao City;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. R07533455 AND CERTIFICATE OF FULL PAYMENT
has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

ADONIS G. NOYNAY
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, APRIL JOY S. SOMOSOT, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of TIN CARD duly issued by Bureau of Internal

Revenue (BIR), Davao City;

That the aforesaid TIN CARD has been inadvertently lost or missing
and despite of diligent efforts to locating and recovering it, the same
could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

APRIL JOY S. SOMOSOT

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EVANGELINE GODINEZ LARA, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Philippine National Bank (PNB), Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

EVANGELINE GODINEZ LARA

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHERRY CLAIRE RUBY GALAURA SARATAO, of legal age,

Filipino, and a resident of Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am the authorized representative of RED SYSTEMS a holder of

ORIGINAL COPY OF LIQUIDATION/REIMBURSEMENTS DOCUMENTS;

That the aforesaid ORIGINAL COPY OF

LIQUIDATION/REIMBURSEMENTS DOCUMENTS has been
inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines
CHERRY CLAIRE RUBY GALAURA SARATAO
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JEFFREY A. PADON, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

JEFFREY A. PADON
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, IRIS KASSANDRA LOZADA LAGOC, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:
That I am a holder of CERTIFICATE OF REGISTRATION (COR)
AND TIN CARD duly issued by Bureau of Internal Revenue (BIR), Davao
City;

That the aforesaid CERTIFICATE OF REGISTRATION (COR) AND

TIN CARD has been inadvertently lost or missing and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 TH

day of October 2015, at Davao City, Philippines

IRIS KASSANDRA LOZADA LAGOC

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 6TH day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARIBETH N. ESPINA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. L12187869D duly issued by St. Peter Life Plan, Inc.,
Davao City;

That the aforesaid ST. PETER LIFE PLAN AGREEMENT WITH

CONTRACT NO. L12187869D has been inadvertently lost or missing and
despite of diligent efforts to locating and recovering it, the same could no
longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of October 2015, at Davao City, Philippines

MARIBETH N. ESPINA
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 5th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, FRANCISCO T. ABONERO JR., of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of DRIVER’S LICENSE duly issued by Land

Transportation Office (LTO), Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost

or missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of October 2015, at Davao City, Philippines

FRANCISCO T. ABONERO JR.

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 5th day of October 2015,
at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JORICH KENLY T. ALNGOG, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of CASH INVOICE w/ control no. 1091801,

1091857, 1091901 duly issued by Washington DC BSPI, Davao City;

That the aforesaid CASH INVOICE w/ control no. 1091801,

1091857, 1091901 has been inadvertently lost or missing and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of October 2015, at Davao City, Philippines
JORICH KENLY T. ALNGOG
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 5th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALRIE S. MATILAC, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Davao Medical School Foundation, Inc. (DMSF), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th
day of October 2015, at Davao City, Philippines

ALRIE S. MATILAC
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 5th day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, AILYN SABIDO TAN, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of PRIVILEGE CARD and REWARD CARD duly

issued by Gaisano Mall of Davao, Davao City;

That the aforesaid PRIVILEGE CARD and REWARD CARD has

been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 ND

day of October 2015, at Davao City, Philippines

AILYN SABIDO TAN

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 2ND day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LESTER L. OCCEÑA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:
That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly
issued by University of Mindanao (UM), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 ND

day of October 2015, at Davao City, Philippines

LESTER L. OCCEÑA
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 2ND day of October
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARISTEL C. GAMUTAN, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of SAVING’S PASSBOOK duly issued by

Landbank, Davao City;

That the aforesaid SAVING’S PASSBOOK has been inadvertently

lost or missing and despite of diligent efforts to locating and recovering it,
the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2015, at Davao City, Philippines

MARISTEL C. GAMUTAN
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, AIMEE P. SAUDOC, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of PAWNPAPER duly issued by Davao Ros-Ver

Pawnshop, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost or

missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2015, at Davao City, Philippines

AIMEE P. SAUDOC
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CAMEL M. LADROMA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of SCHOOL IDENTIFICATION CARD (ID) duly

issued by Holy Cross of Davao College, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2015, at Davao City, Philippines

CAMEL M. LADROMA
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARK LESTER O. ALVARADO, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of OFFICIAL RECEIPT OF RED RIBBON WITH

O.R NO. 0332 duly issued by Department of Foreign Affairs (DFA),
Manila;

That the aforesaid OFFICIAL RECEIPT OF RED RIBBON WITH O.R

NO. 0332 has been inadvertently lost or missing and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st
day of October 2015, at Davao City, Philippines

MARK LESTER O. ALVARADO

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MAIDA D. AGUSTIN, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by One Network Bank (ONB), Piapi Branch, Davao City;
That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD
has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2015, at Davao City, Philippines

MARY ANN DARILAY BERNAT

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARY ANN DARILAY BERNAT, of legal age, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by One Network Bank (ONB), Piapi Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2015, at Davao City, Philippines

MARY ANN DARILAY BERNAT

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JOSE D. DUMDUM, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law
do hereby depose and state:

That I am a holder of AUTOMATED TELLER MACHINE (ATM)

CARD WITH ACCOUNT NO. 307083000027 duly issued by Philippine
National Bank, San Pedro Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

WITH ACCOUNT NO. 307083000027 has been inadvertently lost or
missing and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2015, at Davao City, Philippines

JOSE D. DUMDUM
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 1st day of October 2015,
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RENA MANLIGOY MORALES, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of IPHONE 5 WITH CP NO. 09177205373 duly

issued by Globe Telecommunication;

That the aforesaid IPHONE 5 WITH CP NO. 09177205373 has been

inadvertently lost or missing and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

31st day of February 2015, at Davao City, Philippines

RENA MANLIGOY MORALES

Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 31st day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LETICIA SAMODAN OLEA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the mother of the late FREDDIE OLEA, the holder of a

PASSBOOK duly issued by the Philippines National Bank (PNB);

That the aforesaid PASSBOOK has been inadvertently lost or

missing from our possession since my son passed away, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of February 2015, at Davao City, Philippines
th
LETICIA SAMODAN OLEA
Affiant
Competent Proof of Identity:
TIN: 905-079-655-000
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ANDREW P. BRIGOLI, of legal age, Filipino, and a resident of

Purok 7-A Nograles Avenue, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the owner of a Identification Card describe as follows;

Tax Identification Number (TIN) Card issued by the Bureau of Internal

Revenue (BIR)

Social Security System (SSS) ID issued by the Social Security System

PHIL HEALTH (PHIC) ID issued by the Philippine Health Insurance Inc.

That the aforesaid IDENTIFICATION CARD has been inadvertently

lost or missing from my possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of February 2015, at Davao City, Philippines
th

ANDREW P. BRIGOLI
Affiant
Competent Proof of Identity:
_____________________________
No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, THADEUS JUDE FLORES AYENG, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:
That I am the holder of an IDENTIFICATION CARD, duly issued by
AMOSUP, Davao City;

That the aforesaid IDENTIFICATION CARD has been inadvertently

lost or missing from my possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of February 2015, at Davao City, Philippines

THADEUS JUDE FLORES AYENG

Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-0623420-3
Competent Proof of Identity:SSS No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ELSA SIOSON FRIAS, of legal age, Filipino, and a resident of 782

Calamansi St., Juna Subd., Matina, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a CLAIM STUB from my PRC ID, duly

issued by the Professional Regulations Commission (PRC);

That the aforesaid CLAIM STUB has been inadvertently lost or

missing from my son’s possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of February 2015, at Davao City, Philippines

ELSA SIOSON FRIAS

Affiant
Competent Proof of Identity:
Comelec ID VIN: 2402-1240B-G3066JDL20000
Competent Proof of Identity:SSS No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 20th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JULIET D. LIM, of legal age, Filipino, and a resident of 782

Calamansi St., Juna Subd., Matina, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the mother of ANTONIO D. LIM, grade school student of

Ateneo de Davao University and the holder of a YEAR BOOK
SOLICITATION FORM, from Ateneo de Davao University, Matina Campus,
Davao City;

That the aforesaid YEAR BOOK SOLICITATION FORM has been

inadvertently lost or missing from my son’s possession and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

13th day of February 2015, at Davao City, Philippines

JULIET D. LIM
Affiant
Competent Proof of Identity:
Comelec ID VIN: 2402-1240B-G3066JDL20000
Competent Proof of Identity:SSS No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 13th day of February
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JIMMY GERNALE UY, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of a BUSINESS PLATE, for Philippine General

Merchandising Corporation duly issued by the Business Bureau of Davao
City;

That the aforesaid BUSINESS PLATE has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 day of February 2015, at Davao City, Philippines
th
JIMMY GERNALE UY
Affiant
Competent Proof of Identity:
TIN: 260-625-992
Competent Proof of Identity:SSS No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this 12th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GLENN B. DE TABLAN JR, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD, duly issued by the One Network Bank (ONB), Calinan Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing from my possession and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

______________
, at Davao City, Philippines

GLENN B. DE TABLAN JR
Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:SSS No.: 09-203
9404-5
SUBSCRIBED AND SWORN to before me this ___________________, at
Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KATHLEAH JOY M. LAUREL, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a Bachelor of Elementary Education graduate of Holy

Cross of Davao College, Davao City, last March of 2007;
That I am a holder of a SCHOOL DIPLOMA, duly issued by the Holy
Cross of Davao College, Davao City;

That the aforesaid SCHOOL DIPLOMA has been inadvertently lost

or missing from my possession and despite of diligent efforts to locating
and recovering it, the same could no longer be found, hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of February 2015, at Davao City, Philippines

KATHLEAH JOY M. LAUREL

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-050389732-3
Competent Proof of Identity:SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 6th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, SAHARA R. JORDAN, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD, duly issued by the Veteran’s Bank, Monteverde Branch, Davao
City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing from my possession and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of February 2015, at Davao City, Philippines

SAHARA R. JORDAN
Affiant
Competent Proof of Identity:
PhilHealth No.: 16-050389732-3
Competent Proof of Identity:SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 6th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, CONCEPCION ROSALES MARTINEZ, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of a FORM 137, duly issued by the Maa National

High School, Ma-a, Davao City;

That the aforesaid FORM 137 has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of February 2015, at Davao City, Philippines

CONCEPCION ROSALES MARTINEZ

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-050389732-3
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 5th day of February
2015, at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, REMEDIOS ENRIQUEZ CANOY, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD, duly issued by the GREEN BANK, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing from my possession and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of February 2015, at Davao City, Philippines
REMEDIOS ENRIQUEZ CANOY
Affiant
Competent Proof of Identity:
PRC ID NO. 0870057
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 5th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CORAZON J. MANGUIAT, of legal age, Filipino, and a resident of

Blk. 2 Hs 19 Greenland Subd., Dumoy, Toril, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD, duly issued by the Landbank of the Philippines, C.M. Recto Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost or missing from my possession and despite of
diligent efforts to locating and recovering it, the same could no longer be
found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th
day of February 2015, at Davao City, Philippines

CORAZON J. MANGUIAT
Affiant
Competent Proof of Identity:
_________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 5th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAHMATH YAHIYA RAHEEM, of legal age, Filipino, and a

resident of Isla Verde, Brgy. 23-C, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am a holder of a PASSPORT with number EC2404304,

duly issued by the DFA Cotabato;
That the aforesaid PASSPORT has been inadvertently lost or
missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of February 2015, at Davao City, Philippines

RAHMATH YAHIYA RAHEEM

Affiant
Competent Proof of Identity:
_________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 5th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NIDA M. CABREROS, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:
That I am a holder of an SSS E-1 FORM, PHILHEALTH
IDENTIFICATION CARD, and an AUTOMATED TELLER MACHINE
(ATM) CARD, duly issued by the SSS, PhilHealth, and RCBC, C.M. Recto
Branch, Davao City, respectively;

That the aforesaid SSS E-1 FORM, PHILHEALTH

IDENTIFICATION CARD, and an AUTOMATED TELLER MACHINE
(ATM) CARD have been inadvertently lost or missing from my possession
and despite of diligent efforts to locating and recovering them, the same
could no longer be found, hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of February 2015, at Davao City, Philippines

NIDA M. CABREROS
Affiant
Competent Proof of Identity:
_________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 5th day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SANTOS DEMIAR LUBON, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of an SSS IDENTIFICATION CARD, duly issued

by the SSS of Davao City;

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost or missing from my possession and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015, at Davao City, Philippines

SANTOS DEMIAR LUBON

Affiant
Competent Proof of Identity:
_________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 2nd day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, SANTOS DEMIAR LUBON, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of an SSS IDENTIFICATION CARD, duly issued

by the SSS of Davao City;

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost or missing from my possession and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015, at Davao City, Philippines

SANTOS DEMIAR LUBON

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, IGMEDIO BUSTILLO CORDITA, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of a AMWSLAI PASSBOOK, duly issued by

AMWSLAI, Davao City;

That the aforesaid AMWSLAI PASSBOOK has been inadvertently

lost or missing from my possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015, at Davao City, Philippines
IGMEDIO BUSTILLO CORDITA
Affiant
Competent Proof of Identity:
OSCA ID No.: 82521
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 2nd day of February
2015, at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JEMALYN G. SANCHEZ, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of a CASH INVOICE WITH NUMBER 9112

SOLD TO LTS COMMUNITY STORE INC. for the amount of Php
3,500.00, duly issued by Pizza Pedrico’s Food Corporation;

That the aforesaid CASH INVOICE has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015 at Davao City, Philippines

JEMALYN G. SANCHEZ
Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 2nd day of February
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, TERESA MATILDE D. MARCELINO, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of a HEALTH CARD, duly issued by the City

Health Office;
That the aforesaid HEALTH CARD has been inadvertently lost or
missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015 at Davao City, Philippines

TERESA MATILDE D. MARCELINO

Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 2nd day of February
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DANTE D. SINAJONON, of legal age, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of a DRIVER’S LICENSE duly issued by Land

Transportation Office of Davao City;

That the aforesaid DRIVER’S LICENSE CARD has been

inadvertently lost or missing from my possession and despite of diligent
efforts to locating and recovering it, the same could no longer be found,
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11TH day of February 2015 at Davao City, Philippines

DANTE D. SINAJONON
Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 11TH day of February
2015 at Davao City, Philippines.

Doc. No. 129___; ALEXIS M. LUMBATAN

Page No. ___26____; Notary Public
Book No. ____XLI___; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JUDITH G. APOLINARES, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of a PASSBOOK duly issued by FICCO (First

Community Cooperative) C. Bangoy St., Davao City;

That the aforesaid PASSBOOK has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015 at Davao City, Philippines

JUDITH G. APOLINARES
Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 2nd day of February
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JUDITH G. APOLINARES, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the mother of JEA MARIE G. APOLINARES, minor, Grade 8

student of Mabini National High School, and the holder of a 2ND YEAR
SCIENCE BOOK duly issued by Mabini National High School, Davao City;

That the aforesaid 2ND YEAR SCIENCE BOOK has been

inadvertently lost or missing from my daughter’s possession and despite
of diligent efforts to locating and recovering it, the same could no longer
be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of February 2015 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CLEMENTE P. ESTRELLA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of a P.O. CARD SM ECOLAND duly issued by

SM, Davao City;

That the aforesaid P.O. CARD SM ECOLAND has been

inadvertently lost last August 2014 and despite of diligent efforts to
locating and recovering it, the same could no longer be found, hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
29 day of January 2015 at Davao City, Philippines
th

CLEMENTE P. ESTRELLA
Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 29th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY EVALYN RAMOS-LANTION, of legal age, Filipino, and a

resident #629 Aguho St., Juna Subd., Matina, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am holder of a TIN CARD with number 105-283-694 duly

issued by the Bureau of Internal Revenue;
That the aforesaid TIN CARD has been inadvertently lost or
misplaced, and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of January 2015 at Davao City, Philippines
th

MARY EVALYN RAMOS-LANTION

Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 29th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARY EVALYN RAMOS-LANTION, of legal age, Filipino, and a
resident Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am holder of an SSS IDENTIFICATION CARD and LTO

DRIVER’S LICENSE duly issued by the SSS and LTO of Davao City,;

That the aforesaid SSS IDENTIFICATION CARD and LTO

DRIVER’S LICENSE have been inadvertently lost or misplaced, and
despite of diligent efforts to locating and recovering them, the same could
no longer be found, hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29th day of January 2015 at Davao City, Philippines

GEMMA L. YU
Affiant
Competent Proof of Identity:
CTC No.: 30986732
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 29th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, GEMMA L. YU, of legal age, Filipino, and a resident Davao City,

Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am holder of an SSS IDENTIFICATION CARD and LTO

DRIVER’S LICENSE duly issued by the SSS and LTO of Davao City,;

That the aforesaid SSS IDENTIFICATION CARD and LTO

DRIVER’S LICENSE have been inadvertently lost or misplaced, and
despite of diligent efforts to locating and recovering them, the same could
no longer be found, hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of January 2015 at Davao City, Philippines
th

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, RAMIL GOLES CABALLERO, of legal age, Filipino, and a resident

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am holder of a CASH CARD duly issued by the Landbank of

the Philippines;

That the aforesaid CASH CARD has been inadvertently lost or

misplaced, and despite of diligent efforts to locating and recovering it, the
same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of January 2015 at Davao City, Philippines
th

RAMIL GOLES CABALLERO

Affiant
Competent Proof of Identity:
__________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 29th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAMIL GOLES CABALLERO AISA VANESSA L. CARASCAL, of

legal age, Filipino, and a resident Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am holder of an EMPLOYEE’S IDENTIFICATION CARD duly

issued by SM Lanang Premier, Davao City;

That the aforesaid EMPLOYEE’S COMPANY IDENTIFICATION

CARD has been inadvertently lost or misplaced last January 20, 2015 as I
was headed for work, and despite of diligent efforts to locating and
recovering it, the same could no longer be found, hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of January 2015 at Davao City, Philippines

AISA VANESSA L. CARASCAL

Affiant
Competent Proof of Identity:
__________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 22nd day of January
2015 at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAYNANTE BATILLER PARESA, of legal age, Filipino, and a

resident Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am holder of a SSS CARD duly issued by Social Security

System Davao City;

That the aforesaid SSS CARD has been inadvertently lost and
despite of diligent efforts to locating and recovering them, the same could
no longer be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of January 2015 at Davao City, Philippines
RAYNANTE BATILLER PARESA
Affiant
Competent Proof of Identity:

Competent Proof of Identity:

SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 20th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROMULO N. PADILLA, of legal age, Filipino, and a resident

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Landbank, C.M. Recto Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

have been inadvertently lost and despite of diligent efforts to locating and
recovering them, the same could no longer be found hence, I consider
them lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of January 2015 at Davao City, Philippines
th

ROMULO N. PADILLA
Affiant
Competent Proof of Identity:
SSS ID No.: 09-1952201-9
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 20th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LELIBETH GUMAPAC TAPAO, of legal age, Filipino, and a

resident Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the dicer and holder of ORIGINAL AND DUPLICATE

COPIES OF PURCHASE ORDER with P.O. Date 12-01-14, P.O.#0126599,
Invoice Date 12-02-14, Invoice# 0234 for the amount of Php1,225.00,
billed to LTS City Foods, Inc., and State of Accounts with P.O Date 12-01-
14, P.O # 0126586, Invoice Date 12-02-14, Invoice # 0231,32,32 for the
amount of Php7,531.00 MCCC Building Marfori Metro Circle, Gempesaw
Extension, Sta. Ana Avenue, Davao City;

That the aforesaid ORIGINAL AND DUPLICATE COPIES OF

PURCHASE ORDER have been inadvertently lost and despite of diligent
efforts to locating and recovering them, the same could no longer be
found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of January 2015 at Davao City, Philippines
th

LELIBETH GUMAPAC TAPAO

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ELLEN BALINGIT ESTACCAN, of legal age, Filipino, and a

resident Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a GSIS E-CARD duly issued by the GSIS;

That the aforesaid GSIS E-CARD have been inadvertently lost and
despite of diligent efforts to locating and recovering them, the same could
no longer be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 23

day of June 2015 at Davao City, Philippines

ELLEN BALINGIT ESTACCAN

Affiant
Competent Proof of Identity:
________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 23 day of June 2015 at
Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, LELIBETH GUMAPAC TAPAO, of legal age, Filipino, and a

resident Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the dicer and holder of ORIGINAL AND DUPLICATE

COPIES OF PURCHASE ORDER with P.O. Date 12-01-14, P.O.#0126599,
Invoice Date 12-02-14, Invoice# 0234 for the amount of Php1,225.00,
billed to LTS City Foods, Inc., Gempesaw Extension, Sta. Ana Avenue,
Davao City;

That the aforesaid ORIGINAL AND DUPLICATE COPIES OF

PURCHASE ORDER have been inadvertently lost and despite of diligent
efforts to locating and recovering them, the same could no longer be
found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of January 2015 at Davao City, Philippines
th

LELIBETH GUMAPAC TAPAO

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025354598-1
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 19th day of January
2015 at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2016
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, BENJAMIN A. PETILOS, of legal age, Filipino, and a resident

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD issued by the Veterans Bank, C.M. Recto Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of January 2015 at Davao City, Philippines

BENJAMIN A. PETILOS
Affiant
Competent Proof of Identity:
OSCA ID No.: 14-12618
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 19th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PSYQUE ROSE TINAYTINA, of legal age, Filipino, and a resident

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a HEALTH CARD issued by the Health Card,

Davao City;

That the aforesaid HEALTH CARD has been inadvertently lost and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of January 2015 at Davao City, Philippines
PSYQUE ROSE TINAYTINA
Affiant
Competent Proof of Identity:
_____________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 19th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DANNY A. GRANDE, of legal age, Filipino, and a resident Purok 1

Bunawan, Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:
That I am the holder of a ORIGINAL ST. PETER POLICY WITH
CONTRACT NO. R10647741F and PLANHOLDER’S IDENTIFICATION
CARD issued by the St. Peter Life Plan;

That the aforesaid ORIGINAL ST. PETER POLICY WITH

CONTRACT NO. R10647741F and PLANHOLDER’S IDENTIFICATION
CARD has been inadvertently lost and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of January 2015 at Davao City, Philippines
th

DANNY A. GRANDE
Affiant
Competent Proof of Identity:
_____________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 16th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, FE MARIE D. JULVE, of legal age, Filipino, and a resident P-3 Blk.

6 L-11, NHA Kadayawan Homes, Bangkal, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a NATIONAL HOME MORTGAGE FINANCE

CORP. IDENTIFICATION CARD issued by NHMFC, Davao City;

That the aforesaid NATIONAL HOME MORTGAGE FINANCE

CORP. IDENTIFICATION CARD has been inadvertently lost and despite
of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of January 2015 at Davao City, Philippines
th

FE MARIE D. JULVE
Affiant
Competent Proof of Identity:
_____________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 19th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, DANNY A. GRANDE, of legal age, Filipino, and a resident NHA

Seaside Purok 59, Bangkal, of Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a PLANHOLDER’S IDENTIFICATION CARD

issued by the St. Peter Life Plan;

That the aforesaid PLANHOLDER’S IDENTIFICATION CARD has

been inadvertently left inside a taxicab and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of January 2015 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MANUEL REMEDIOS MALBAS JR., of legal age, Filipino, and a

resident NHA Seaside Purok 59, Bangkal, of Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a Drivers License issued by the Land

Transportation Office (LTO), Davao Branch placed inside my wallet for safe
keeping ;

That last January 7, 2015 when I was in our home and having a
party the aforesaid Drivers License was placed inside my wallet was lost
or drop in my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

15 day of January 2015 at Davao City, Philippines
th

MANUEL REMEDIOS MALBAS JR

Affiant
Competent Proof of Identity:
_____________________________
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 15th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LORENZO C. EBITA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a PAWNPAPER with number 0824014,

for a bracelet item, duly issued by Gemmary Pawnshop, Davao Branch;

That the aforesaid PAWNPAPER has been inadvertently left inside

a taxicab and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12th day of January 2015 at Davao City, Philippines
LORENZO C. EBITA
Affiant
Competent Proof of Identity:
SSS No.: 09-2039404-5
SUBSCRIBED AND SWORN to before me this 12th day of January
2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 5034435-01/06/15- Davao City
IBP OR. No. 0980059-01/06/15-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ESTERLITA ESTUDILLO PESCADERO, of legal age, Filipino, and

a resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT WITH NO.

XX0445502, duly issued by the Department of Foreign Affairs, Davao
City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

left inside a taxicab and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 day of January 2015 at Davao City, Philippines
th

ESTERLITA ESTUDILLO PESCADERO

Affiant
Competent Proof of Identity:
SSS No.: 09-2039404-5

SUBSCRIBED AND SWORN to before me this 12th day of January

2015 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2015. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ATTY. ANGELA A. LIBRADO, of legal age, Filipino, and a resident
of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a ORIGINAL COPY OF PROGRAM OF

WORKS AND PLAN for the following projects;

1. Concreting of Road at Guadalupe 3, Matina Crossing

2. Concreting of Road at Gravahan 2, Matina Crossing
3. Concreting of Road at Gravahan 3, Matina Crossing

That the aforesaid ORIGINAL COPY OF PROGRAM OF WORKS

AND PLAN has been inadvertently lost or missing from my possession
and despite of diligent efforts to locating and recovering it, the same
could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2015 at Davao City, Philippines

ATTY. ANGELA A. LIBRADO

Affiant
Competent Proof of Identity:
_________________________________

SUBSCRIBED AND SWORN to before me this 8th day of January 2015

at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, TED V. DELOS SANTOS, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a PAWNTICKET with RECEIPT NO. 0301-

2014-01429, duly issued by MLhuillier, Buhangin Branch, Davao City;

That the aforesaid PAWNTICKET has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2015 at Davao City, Philippines

TED V. DELOS SANTOS

Affiant
Competent Proof of Identity:
_________________________________

SUBSCRIBED AND SWORN to before me this 8th day of January 2015

at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JOSEPHINE T. MIGELLANO, of legal age, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a PAWNTICKET with number 34082, for 2

earrings duly issued by Agencia Kimsan Ponciano Reyes, Inc., Puan
Branch, Davao City;

That the aforesaid PAWNTICKET has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of January 2015 at Davao City, Philippines

JOSEPHINE T. MIGELLANO
Affiant
Competent Proof of Identity:
SSS No.: 09-1058031-9

SUBSCRIBED AND SWORN to before me this 8th day of January 2015

at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSEFINA S. SINGSON, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a CHECKBOOK with numbers 1747958 to

1748000, under Carhen Rhenn Ronda Chua or Josefina Santiago Singson
with Account Number 001-358-0000-7358016703 duly issued by
Metrobank, Matina Branch, Davao City;

That the aforesaid CHECKBOOK has been inadvertently lost or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of January 2015 at Davao City, Philippines

JOSEFINA S. SINGSON
Affiant
Competent Proof of Identity:
SSS No.: 03-3341261-1

SUBSCRIBED AND SWORN to before me this 7th day of January 2015

at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

I, SANNY MAE GUTIERREZ, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the authorized of RBCJ Pharmacy and that the said

company holder of a SALES MAN COPY OF SALES INVOICE NO.
33O75 WITH C.R. NO. 62497 UNDER NAME OF TAN IBONIA AND
SALES INVOICE NO. 24987 WITH C.R. NO. 53194 UNDER NAME OF
JENIE TAN, duly issued by RBCJ Pharmacy, Davao City;

That the aforesaid SALES MAN COPY OF SALES INVOICE NO.

33O75 WITH C.R. NO. 62497 UNDER NAME OF TAN IBONIA AND
SALES INVOICE NO. 24987 WITH C.R. NO. 53194 UNDER NAME OF
JENIE TAN has been inadvertently lost or missing and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of January 2015 at Davao City, Philippines

SANNY MAE GUTIERREZ

Affiant
Competent Proof of Identity:
Company ID No.: 10122069

SUBSCRIBED AND SWORN to before me this 5th day of January 2015

at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, RENEE MAE D. AGUSTIN, of legal age, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD (ID),

duly issued by ATENEO DE DAVAO UNIVERSITY (ADDU), Jacinto Campus,
Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost or missing from my possession and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of January 2015 at Davao City, Philippines

RENEE MAE D. AGUSTIN

Affiant
Competent Proof of Identity:
Itfggsdg
SUBSCRIBED AND SWORN to before me this 5th day of January 2015
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, NARCISO CLEMENT, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:
That I am the holder of a SCHOOL IDENTIFICATION CARD (ID),
duly issued by University of Immaculate Conception (UIC), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost, or missing from my possession and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of January 2015 at Davao City, Philippines

NARCISO CLEMENT
Affiant
Competent Proof of Identity:
Itfggsdg
SUBSCRIBED AND SWORN to before me this 5th day of January 2015
at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RENNIEL S. DELA CERNA, of legal age, Filipino, and a resident of

Doña Salud, Sasa, Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the holder of a RE under No. 0031728, duly issued by

Cebuana Lhuiller Pawnshop, Sandawa Branch, Davao City;

That the aforesaid REGISTERED MASTER ELECTRICIAN LICENSE

has been inadvertently lost, or missing from my possession last December
11, 2014 at our office in Manila, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of December 2014 at Davao City, Philippines

RENNIEL S. DELA CERNA

Affiant
Competent Proof of Identity:
Itfggsdg
SUBSCRIBED AND SWORN to before me this 22nd day of December
2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, IVY CABILIN MORENO, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a PAWN TICKET with # 60680sg001876,

duly issued by Cebuana Lhuiller Pawnshop, Sandawa Branch, Davao City;

That the aforesaid PAWN TICKET has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
22nd day of December 2014 at Davao City, Philippines

IVY CABILIN MORENO

Affiant
Competent Proof of Identity:
SSS No.: 09-1871990-4

SUBSCRIBED AND SWORN to before me this 22nd day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ABUNDIO VALLESPIN DURAY JR., of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a BANK BOOK, duly issued by the Philippine

National Bank, Bankerohan Branch, Davao City;

That the aforesaid BANK BOOK has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of December 2014 at Davao City, Philippines
ABUNDIO VALLESPIN DURAY JR.
Affiant
Competent Proof of Identity:
LTO License No.: L02-05-001001

SUBSCRIBED AND SWORN to before me this 22nd day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JESSON VILLAMOR BARQUIN, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a DRIVER’S LICENSE, duly issued by the

Land Transportation Office of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

or missing from my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of December 2014 at Davao City, Philippines

JESSON VILLAMOR BARQUIN

Affiant
Competent Proof of Identity:
OSCA ID No.: 14-261
SUBSCRIBED AND SWORN to before me this 22nd day of December
2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FLORIANO D. SAMSON, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a SSS IDENTIFICATION CARD, duly issued

by the SSS, Davao City;

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of December 2014 at Davao City, Philippines

FLORIANO D. SAMSON
Affiant
Competent Proof of Identity:
OSCA ID No.: 14-261

SUBSCRIBED AND SWORN to before me this 22nd day of December

2014 at Davao City, Philippines.
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2014. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ARMY JOY A. ERAMIS, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a PROFFESIONAL REGULATION

COMMISSION (PRC) CLAIM SLIP, duly issued by the PRC, Davao City;

That the aforesaid PROFFESIONAL REGULATION COMMISSION

(PRC) CLAIM SLIP has been inadvertently lost, or missing from my
possession, and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19 day of December 2014 at Davao City, Philippines
th

ARMY JOY A. ERAMIS

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025481068-9

SUBSCRIBED AND SWORN to before me this 19th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, TROADIO T. ENGYO, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD, duly issued by Bank of the Philippine Islands, Bajada Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, or missing from my possession, and despite
of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of December 2014 at Davao City, Philippines

TROADIO T. ENGYO
Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025481068-9

SUBSCRIBED AND SWORN to before me this 19th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

I, KRISTAL JOY BARRETE CHOON, of legal age, single, Filipino,

and a resident of Doña Vicenta, Bajada, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the authorize representative of CENTURY COFFEE

MANUFACTURING and the holder of a PHILHEALTH RECEIPT issued to
the company for payment of the month of November 2014, duly issued by
PhilHealth, Davao City;

That the aforesaid PHILHEALTH RECEIPT has been inadvertently

lost, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 day of December 2014 at Davao City, Philippines
th

KRISTAL JOY BARRETE CHOON

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025481068-9

SUBSCRIBED AND SWORN to before me this 12th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, RYAN LIBRODO BALADHAY, of legal age, married, Filipino, and
a resident of Blk 32 Lot 11 Rosalina 3, Toril, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a TIN CARD duly issued by the Bureau of

Internal Revenue (BIR), Davao City;

That the aforesaid TIN CARD has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of December 2014 at Davao City, Philippines

RYAN LIBRODO BALADHAY

Affiant
Competent Proof of Identity:
TIN: 271-566-394

SUBSCRIBED AND SWORN to before me this 10th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, TERESITA D. VITOR, of legal age, married, Filipino, and a

resident of Blk 24 Lot 7 Woodridge Park, Ma-a, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:
That I am the holder of a CERTIFICATE OF REGISTRATION under
TIN 409-778-617-000 duly issued by the Bureau of Internal Revenue (BIR),
Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of December 2014 at Davao City, Philippines
th

TERESITA D. VITOR
Affiant
Competent Proof of Identity:
TIN: 271-566-394

SUBSCRIBED AND SWORN to before me this 10th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, MAY JOY BISCUCHO AREVALO, of legal age, Filipino, and a

resident of North San Juan Village, Centro, Agdao, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the Development Bank of the Philippines (DBP), C.M.
Recto Branch, Davao City;
That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD
has been inadvertently lost, or missing from my possession, and despite
of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of December 2014 at Davao City, Philippines
th

MAY JOY BISCUCHO AREVALO

Affiant
Competent Proof of Identity:
Comelec ID VIN: 2402-1857A-E0389MBA20000

SUBSCRIBED AND SWORN to before me this 10th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NENITO BAJADE BABAYEN-ON, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of an ST. PETER LIFE PLAN IDENTIFICATION

CARD under policy number 537389 duly issued by St. Peter Life Plan
Incorporated;

That the aforesaid ST. PETER LIFE PLAN IDENTIFICATION CARD

has been inadvertently lost, or missing from my possession, and despite
of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of December 2014 at Davao City, Philippines
th

NENITO BAJADE BABAYEN-ON

Affiant

SUBSCRIBED AND SWORN to before me this 10th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JUVY B. CASTAÑEDA, of legal age, Filipino, and a resident of Blk

17, Lot 26, Rosalina 3, Brgy. Baliok, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the Philippine National Bank (PNB), Matina Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, or missing from my possession, and despite
of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of December 2014 at Davao City, Philippines
th

JUVY B. CASTAÑEDA
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, LOURDESITA CABUEÑAS HINAMPAS, of legal age, married,

Filipino, and a resident of Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am the holder of a CLAIM STUB OF R.O.D duly issued by

That the aforesaid CLAIM STUB OF R.O.D has been inadvertently

lost, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2014 at Davao City, Philippines
LOURDESITA CABUEÑAS HINAMPAS
Affiant
POSTAL ID NO. 1562392
Competent Proof of Identity:
UM-P ID No.: CRN-0111-2957519-8

SUBSCRIBED AND SWORN to before me this 4th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROBELYN A. SANIOR, of legal age, single, Filipino, and a resident

of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a SCHOOL CARD duly issued by Mataas na

Paaralang Pambansa ng Bernardo D. Carpio, Davao City;

That the aforesaid SCHOOL CARD has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2014 at Davao City, Philippines

ROBELYN A. SANIOR
Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-2957519-8

SUBSCRIBED AND SWORN to before me this 4th day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ABIGAIL DELA SALDE, of legal age, single, Filipino, and a

resident of Gravahan, Matina, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD duly

issued by the University of Mindanao (UM), Matina, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of December 2014 at Davao City, Philippines

ABIGAIL DELA SALDE

Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-2957519-8

SUBSCRIBED AND SWORN to before me this 4th day of December

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DULCE R. DELEQUIADO, of legal age, single, Filipino, and a

resident of Banaybanay, Davao Oriental, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a HIGH SCHOOL IDENTIFICATION CARD

duly issued by Davao Wisdom Academy, Torres St., Davao City;

That the aforesaid HIGH SCHOOL IDENTIFICATION CARD has

been inadvertently lost, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of December 2014 at Davao City, Philippines

DULCE R. DELEQUIADO
Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-2957519-8

SUBSCRIBED AND SWORN to before me this 3rd day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, MARIA ALICIA BENTOSO NAJERA, of legal age, married, Filipino,

and a resident of 718 Tindalo St., Poly Subd., Matina, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a PAWNPAPER for a gold diamond ring

issued by Helen’s Pawnshop, NCCC Mall Branch, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2014 at Davao City, Philippines

MARIA ALICIA BENTOSO NAJERA

Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-2957519-8

SUBSCRIBED AND SWORN to before me this 1st day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

I, RAFAEL C. MARTELINO, of legal age, married, Filipino, and a

resident of Lot 20 Blk 20 NHA Bangkal, Kadawayan Homes, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a CERTIFICATE OF REGISTRATION under

TIN 271-566-394 duly issued by the Bureau of Internal Revenue (BIR),
Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2014 at Davao City, Philippines

RAFAEL C. MARTELINO
Affiant
Competent Proof of Identity:
TIN: 271-566-394

SUBSCRIBED AND SWORN to before me this 1st day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, RAFAEL C. MARTELINO, of legal age, married, Filipino, and a
resident of Lot 20 Blk 20 NHA Bangkal, Kadawayan Homes, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a CERTIFICATE OF REGISTRATION under

TIN 271-566-394 duly issued by the Bureau of Internal Revenue (BIR),
Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of December 2014 at Davao City, Philippines

RAFAEL C. MARTELINO
Affiant
Competent Proof of Identity:
TIN: 271-566-394

SUBSCRIBED AND SWORN to before me this 1st day of December

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, BELINDA A. DELOS SANTOS, of legal age, married, Filipino, and

a resident of Alegrea, Cateel, Davao Oriental, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:
That I am the holder of a PAWNPAPER with Receipt No. 0891-2014-
00044 for items Cross Pendant and Necklace duly issued by M Lhuillier,
Cateel Branch, Cateel, Davao Oriental;

That the aforesaid PAWNPAPER has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28th day of November 2014 at Davao City, Philippines

BELINDA A. DELOS SANTOS

Affiant
Competent Proof of Identity:
PRC No.: 0403186

SUBSCRIBED AND SWORN to before me this 28th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, PATRICIO M. BARNES, of legal age, widower, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PASSBOOK under account no. 3149 9660

0028 duly issued by the Philippine National Bank (PNB), Matina Branch,
Davao City;
That the aforesaid PASSBOOK has been inadvertently lost, or
missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28th day of November 2014 at Davao City, Philippines

PATRICIO M. BARNES
Affiant

SUBSCRIBED AND SWORN to before me this 28th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JEANETTE LIM PARAS, of legal age, married, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PAWNPAPER with Pawn No. 47599 with a

principal of P7,000.00 duly issued by Rosegold Pawnshop, Buhangin
Branch, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28 day of November 2014 at Davao City, Philippines
th

JEANETTE LIM PARAS

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025126798-4

SUBSCRIBED AND SWORN to before me this 28th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, JEANETTE LIM PARAS, of legal age, married, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PAWNPAPER with Pawn No. 47598 with a

principal of P6,200.00 duly issued by Rosegold Pawnshop, Buhangin
Branch, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28th day of November 2014 at Davao City, Philippines
JEANETTE LIM PARAS
Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025126798-4

SUBSCRIBED AND SWORN to before me this 28th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ARLYN IYO RUMBAL, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a CERTIFICATE OF REGISTRATION under

TIN 938-487-905-000 duly issued by the Bureau of Internal Revenue (BIR),
Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28 day of November 2014 at Davao City, Philippines
th
ARLYN IYO RUMBAL
Affiant

SUBSCRIBED AND SWORN to before me this 28th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, METCHELLE BANDERA NAUTAN, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost, or missing from my possession last May 2012, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of January 2015 at Davao City, Philippines

METCHELLE BANDERA NAUTAN

Affiant
Competent Proof of Identity:
VIN: 2402-1553B-G0785MBN20000
SUBSCRIBED AND SWORN to before me this 5th day of January 2015
at Davao City, Philippines.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2015.

AFFIDAVIT OF LOSS

I, JHON PAUL BATALLA, of legal age, Filipino, and a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a PAWNPAPER with description item

Iphone 5c with sim and charger serial no. F78L8GDBFM21 duly
issued by Safety Pawnshop, San Pedro St., Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26th day of November 2014 at Davao City, Philippines

JHON PAUL BATALLA

Affiant

SUBSCRIBED AND SWORN to before me this 26th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NELSON JOSEPH P. GRANADA, of legal age, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a DRIVER`S LICENSE with ID NO. L02-

06008895;

That the aforesaid DRIVER`S LICENSE with ID NO. L02-

06008895 has been inadvertently lost, or missing from my possession,
and despite of diligent efforts to locating and recovering it, the same
could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of November 2014 at Davao City, Philippines
th

NELSON JOSEPH P. GRANADA

Affiant

SUBSCRIBED AND SWORN to before me this 26th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, KATHERINE C. HNAMPAS, of legal age, single, Filipino, and a
resident of Purok 20 New Loon, Mintal, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a COMPANY IDENTIFICATION CARD duly

issued by Offsourcing Philippines, Inc., Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of November 2014 at Davao City, Philippines
th

KATHERINE C. HNAMPAS
Affiant

SUBSCRIBED AND SWORN to before me this 26th day of November

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARISA BALUCAN PONTILLANO, of legal age, widow, Filipino,
and a resident of Trading Blvd., Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:
That I am the holder of a PASSPORT duly issued by the
Department of Foreign Affairs of Davao City;

That the aforesaid PASSPORT has been inadvertently lost, or

missing from my possession last November 24, 2014 at 8:00 AM while I
was inside the San Pedro Cathedral, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26th day of November 2014 at Davao City, Philippines

MARISA BALUCAN PONTILLANO

Affiant
Competent Proof of Identity:
Comelec ID VIN: 4209-0074A-C2376MBP20000

SUBSCRIBED AND SWORN to before me this 26th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, JAY MARLOU CALAYO DANDOY, of legal age, single, Filipino,
and a resident of Prk 18, Ideal, Bago Aplaya, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a HEALTHCARD duly issued by City Health

Office of Davao City;
That the aforesaid HEALTHCARD has been inadvertently lost, or
missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26th day of November 2014 at Davao City, Philippines

JAY MARLOU CALAYO DANDOY

Affiant
Competent Proof of Identity:
TIN: 458-756-844-000

SUBSCRIBED AND SWORN to before me this 26th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MA. ROWENA P. DE ASIS, of legal age, single, Filipino, and a
resident of Bucana Kalanganan, Cotabato City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD duly

issued by University of Mindanao, Matina Campus;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
25 day of November 2014 at Davao City, Philippines
th

MA. ROWENA P. DE ASIS

Affiant

SUBSCRIBED AND SWORN to before me this 25th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JUNAS N. SANGO, of legal age, married, Filipino, and a resident
of Toril, Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a AUTOMATED TELLER MACHINE (ATM)

duly issued by Banco De Oro, Cubao, Metro Manila Branch;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) has

been inadvertently lost, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24th day of November 2014 at Davao City, Philippines
JUNAS N. SANGO
Affiant
Competent Proof of Identity:
_______________________________

SUBSCRIBED AND SWORN to before me this 24th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, BENITA PAGUE NACIONALES, of legal age, married, Filipino, and
a resident of Deca Homes, Cabantian, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a E-Card with account # 109590700110

duly issued by the Union Bank locatrd at JP Laurel Ave., Bajada, Davao
City;

That the aforesaid E-Card has been inadvertently lost, or missing

from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of November 2014 at Davao City, Philippines
th

BENITA PAGUE NACIONALES

Affiant
Competent Proof of Identity:
OSCA ID No.: 2223

SUBSCRIBED AND SWORN to before me this 24th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JOSEPH ELMER G. NOVAL, of legal age, married, Filipino, and a
resident of 127 Diamond Ave., Pampanga, Executive Homes Lanang,
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a CASH CARD LAND BANK OF THE

PHILIPPINES with Card No. 6031310160405112 duly issued by the
LAND BANK OF THE PHILIPPINES, Davao City;

That the aforesaid CASH CARD LAND BANK OF THE

PHILIPPINES with Card No. 6031310160405112 has been
inadvertently lost, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of November 2014 at Davao City, Philippines
th

JOSEPH ELMER G. NOVAL

Affiant
Competent Proof of Identity:
________________________________
SUBSCRIBED AND SWORN to before me this 20th day of November
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, NONIETA GINDAP REALES, of legal age, married, Filipino, and a
resident of Blk 5 Lot 4 Luna St., Mutual Homes, Communal, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a MILITARY DEPENDENT

IDENTIFICATION CARD and AVON FRANCHISE DEALER
IDENTIFICATION CARD duly issued by the AFP and Avon;

That the aforesaid MILITARY DEPENDENT IDENTIFICATION

CARD and AVON FRANCHISE DEALER IDENTIFICATION CARD have
been inadvertently lost, or missing from my possession, and despite of
diligent efforts to locating and recovering them, the same could no longer
be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of November 2014 at Davao City, Philippines
th

NONIETA GINDAP REALES

Affiant
Competent Proof of Identity:
CTC No.: 01842594

SUBSCRIBED AND SWORN to before me this 20th day of November

2014 at Davao City, Philippines
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2014. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JASMINE I. DITANONGUN, of legal age, single, Filipino, and a
resident of Brgy. 23, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a AUTOMATED TELLER MACHINE (ATM)

CARD under Account Number 3260113465 duly issued by the Banco
de Oro, Quirino branch;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, or missing from my possession, and despite
of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of November 2014 at Davao City, Philippines

JASMINE I. DITANONGUN
Affiant
Competent Proof of Identity:
TIN: 945-839-395

SUBSCRIBED AND SWORN to before me this 20th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, DANIEL DANGANON CASTILLON, of legal age, married, Filipino,
and a resident of Davao City Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the holder of a TIN CARD under TIN 946-908-828-000

duly issued by the Bureau of Internal Revenue;

That the aforesaid TIN CARD has been inadvertently lost, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of November 2014 at Davao City, Philippines
th

DANIEL DANGANON CASTILLON

Affiant

SUBSCRIBED AND SWORN to before me this 20th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DELMA LIYAWAN PATIS, of legal age, married, Filipino, and a
resident of Matina Aplaya, Davao City Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs, Davao City;

That the aforesaid PHILIPPINE PASSPORT that the said passport

was put on envelope has been inadvertently lost, or missing from my
possession, and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of November 2014 at Davao City, Philippines

DELMA LIYAWAN PATIS

Affiant
Competent Proof of Identity:
____________________________________

SUBSCRIBED AND SWORN to before me this 19th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, ERNESTO RODRIGO PANSUELO, of legal age, married,
Filipino, and a resident of Del Rosario St. Jerome Ext. Barangay R. Castillo,
Agdao, Davao City Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a DIPLOMA duly issued by the Davao City

High School dated last March 27, 1990;
That the aforesaid DIPLOMA has been inadvertently lost,
misplaced, or missing from my possession, and despite of diligent efforts
to locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of November 2014 at Davao City, Philippines
th

ERNESTO RODRIGO PANSUELO

Affiant
Competent Proof of Identity:
SSS ID No.: 09-1491779-7

SUBSCRIBED AND SWORN to before me this 14th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MELBART G. BERSABAL, of legal age, single, Filipino, and a
resident of Block F12, Lot 6, S.I.R. P-2, Brgy. 76-A, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (LTO) of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of November 2014 at Davao City, Philippines

MELBART G. BERSABAL
Affiant

SUBSCRIBED AND SWORN to before me this 7th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARICHU CACCAM LIONG of legal age, married, Filipino, and a
resident of #24 Aranga St., Phase I SIR New Matina, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a ID duly issued by the Felcris, Ilustre of

Davao City;
That the aforesaid ID has been inadvertently lost, dropped, or
missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of November 2014 at Davao City, Philippines

MARICHU CACCAM LIONG

Affiant
Competent Proof of Identity:
CTC No.:____________________

SUBSCRIBED AND SWORN to before me this 7th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, NANITH O. GONZALES, of legal age, married, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a CERTIFICATE OF HONORABLE

DISMISSAL duly issued by the Holy Cross of Davao College;

That the aforesaid CERTIFICATE OF HONORABLE DISMISSAL has

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of November 2014 at Davao City, Philippines

NANITH O. GONZALES
Affiant

SUBSCRIBED AND SWORN to before me this 6th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ANA M. ORTIS, of legal age, married, Filipino, and a resident of
314 Sandawa, Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a SSS ID and VOTER’S ID duly issued by

the SSS and Comelec, respectively;

That the aforesaid SSS ID and VOTER’S ID have been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering them, the same could no longer
be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th

day of November 2014 at Davao City, Philippines
ANA M. ORTIS
Affiant

SUBSCRIBED AND SWORN to before me this 6th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DARYL DELA CERNA STA. IGLESIA, of legal age, single, Filipino,
and a resident of Purok 8, Tacunan, Mintal, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a SOLICITATION FORM duly issued by Holy

Cross of Davao, Mintal Campus;

That the aforesaid SOLICITATION FORM has been inadvertently

lost, dropped, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of November 2014 at Davao City, Philippines

DARYL DELA CERNA STA. IGLESIA

Affiant
Competent Proof of Identity:
TIN: 438-561-078-000

SUBSCRIBED AND SWORN to before me this 5th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ELIZABETH ALBERCA ANITO, of legal age, Filipino, and a
resident of #072 Km. 5, Buhangin, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a CERTIFICATION WITH SECTOR:

BEGONIA, BLOCK: 28, LOTS: 8 PRIME, 9 PRIME, 10 PRIME duly
issued by the Davao Orchard Road, Davao City;

That the aforesaid CERTIFICATION have been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering them, the same could no longer be found hence, I
consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of November 2014 at Davao City, Philippines

ELIZABETH ALBERCA ANITO

Affiant

SUBSCRIBED AND SWORN to before me this 5th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, LIZYL L. LOSAÑES, of legal age, single, Filipino, and a resident of
Ponce St., Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD duly

issued by the University of Immaculate Concepcion (UIC), Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD have been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering them, the same could no longer
be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of November 2014 at Davao City, Philippines

LIZYL L. LOSAÑES
Affiant

SUBSCRIBED AND SWORN to before me this 5th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DONARD MANARIN REYES, of legal age, single, Filipino, and a
resident of Ecoland, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a PNP IDENTIFICATION CARD, PSSLAI

ATM CARD, and PSBMAI ATM CARD, duly issued by their respective
agencies;

That the aforesaid PNP IDENTIFICATION CARD, PSSLAI ATM

CARD, and PSBMAI ATM CARD have been inadvertently lost, dropped,
or missing from my possession, and despite of diligent efforts to locating
and recovering them, the same could no longer be found hence, I consider
them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of November 2014 at Davao City, Philippines

DONARD MANARIN REYES

Affiant
Competent Proof of Identity:
PhilHealth ID No.: 16-000070979-1

SUBSCRIBED AND SWORN to before me this 5th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, CHARLENE LINDO VERDEFLOR, of legal age, single, Filipino,
and a resident of Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the holder of a TIN CARD duly issued by the Bureau of

Internal Revenue (BIR), Davao City;

That the aforesaid TIN CARD has been inadvertently lost, dropped,
or missing from my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of November 2014 at Davao City, Philippines

CHARLENE LINDO VERDEFLOR

Affiant
Competent Proof of Identity:
Comelec ID VIN: 6803-0004A-J0986CLV20000-2

SUBSCRIBED AND SWORN to before me this 4th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, MILA ANIMO BAISAC, of legal age, married, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PAWNPAPER for a Digital Camera duly

issued by Rosver Pawnshop, Buhangin Branch, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of November 2014 at Davao City, Philippines

MILA ANIMO BAISAC

Affiant
Competent Proof of Identity:
SSS ID No.: 08-1023448-0

SUBSCRIBED AND SWORN to before me this 4th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, REDIN TALISIC, of legal age, single, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of a AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by Security Bank, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of November 2014 at Davao City, Philippines

REDIN TALISIC
Affiant

SUBSCRIBED AND SWORN to before me this 4th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JHON MARK B. QUIAPO, of legal age, single, Filipino, and a
resident of Calinan, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a GOOD MORAL and HIGH SCHOOL CARD

duly issued by the Inayangan National High School, Calinan Davao City;
That the aforesaid GOOD MORAL and HIGH SCHOOL CARD has
been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of November 2014 at Davao City, Philippines

JHON MARK B. QUIAPO

Affiant

SUBSCRIBED AND SWORN to before me this 4th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JANER L. PALMES, of legal age, married, Filipino, and a resident
of Ilang, Tibungco, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (LTO) of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of November 2014 at Davao City, Philippines

JANER L. PALMES
Affiant

SUBSCRIBED AND SWORN to before me this 4th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ROSEBELLE P. MASALING, of legal age, single, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PAWNPAPER under number PT-2966

for a 7gram chain necklace worth P600.00 duly issued b3.y Feroce
Pawnshop, Ilustre Branch, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of November 2014 at Davao City, Philippines
ROSEBELLE P. MASALING
Affiant

SUBSCRIBED AND SWORN to before me this 4th day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, AYESHA MAE T. ISLAO, of legal age, single, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of an TIN ID duly issued by Bureau Of Internal

Revenue (BIR) Davao City;

That the aforesaid TIN ID has been inadvertently lost, dropped, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of November 2014 at Davao City, Philippines

AYESHA MAE T. ISLAO

Affiant
Competent Proof of Identity:
UMID ID NO. 0111-2604199-7
SUBSCRIBED AND SWORN to before me this 3rd day of November
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, CHIELA MAE ODIONG, of legal age, single, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of an GOOD MORAL and REPORT CARD

HIGH SCHOOL duly issued by Bernardo D. Carpio National High School,
Davao City;

That the aforesaid GOOD MORAL and REPORT CARD HIGH

SCHOOL has been inadvertently lost, dropped, or missing from my
possession, and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of November 2014 at Davao City, Philippines

CHIELA MAE ODIONG

Affiant
Competent Proof of Identity:
____________________

SUBSCRIBED AND SWORN to before me this 3rd day of November

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JOIE E. AGUIRRE, of legal age, single, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of an PASSBOOK duly issued by TAGUM

COOPERATIVE Davao City Branch;

That the aforesaid PASSBOOK has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of November 2014 at Davao City, Philippines

JOIE E. AGUIRRE
Affiant
Competent Proof of Identity:
___________________________

SUBSCRIBED AND SWORN to before me this 3rd day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, ZALDY B. APORTO, of legal age, married, Filipino, and a resident
of Jacinto St., Brgy 32-D, Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am the holder of an OFFICIAL RECEIPT with number

439407080 for a KIA Pride Vehicle, duly issued by the Land
Transportation Office (LTO) of Davao City;

That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of November 2014 at Davao City, Philippines

ZALDY B. APORTO
Affiant
Competent Proof of Identity:
CTC No.: 13823222

SUBSCRIBED AND SWORN to before me this 3rd day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, SATORNINO S. AHON, of legal age, Filipino, and a resident of
Sandawa, Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a HEALTH CARD, duly issued by the City

Health Office (CHO) of Davao City;

That the aforesaid HEALTH CARD has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of November 2014 at Davao City, Philippines

SATORNINO S. AHON
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of November

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MICHAEL ROY LIBRANDO TAYOM of legal age, Filipino, and a
resident of Salmonan, Agdao, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:
That I am the holder of an OFFICIAL RECEIPT with OR No.
609742405 issued last August 15, 2008 under CR No. 7209136-4,
duly issued by the Land Transportation Office (LTO) of Davao City;

That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

31 day of October 2014 at Davao City, Philippines
st

MICHAEL ROY LIBRANDO TAYOM

Affiant
Competent Proof of Identity:
Drivers License No. L02-05-004236

SUBSCRIBED AND SWORN to before me this 31st day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, GILBERT C. FABIAN, of legal age, Filipino, and a resident of
Waterlily Village, Brgy. Aquino, Agdao, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a wallet that contained my TIN CARD,

DRIVER’S LICENSE, AGDAO COOPERATIVE IDENTIFICATION CARD,
and an AUTOMATED TELLER MACHINE (ATM) CARD duly issued by
the Bank of Commerce, City Hall Drive, Davao City;

That the aforesaid TIN CARD, DRIVER’S LICENSE, AGDAO

COOPERATIVE IDENTIFICATION CARD, and an AUTOMATED TELLER
MACHINE (ATM) CARD have been inadvertently lost, dropped, or
missing from my possession, and despite of diligent efforts to locating and
recovering them, the same could no longer be found hence, I consider
them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30th day of October 2014 at Davao City, Philippines;

GILBERT C. FABIAN
Affiant

SUBSCRIBED AND SWORN to before me this 30th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, LEONOR DUMAGUETE CONLAS, of legal age, Filipino, and a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a VEHICLE PLATE with number 3350LR,

duly issued by the Land Transportation Office (LTO) of Davao City;

That the aforesaid VEHICLE PLATE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2014 at Davao City, Philippines
th

LEONOR DUMAGUETE CONLAS

Affiant
Competent Proof of Identity:
SSS ID No.: 09-1870130-7

SUBSCRIBED AND SWORN to before me this 30th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DAISY LOU G. BALANGUE, of legal age, Filipino, and a resident
of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

I am the employee of TWA, Inc. Flying V and the holder of a

GREEN RECEIVING REPORT with R.R. No. 12745, duly issued by TWA,
Inc. Flying V, Davao City;

That the aforesaid GREEN RECEIVING REPORT has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30th day of October 2014 at Davao City, Philippines

DAISY LOU G. BALANGUE

Affiant

SUBSCRIBED AND SWORN to before me this 30th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, DERRICK UY, of legal age, Filipino, and a resident of Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a Automated Teller Machine duly issued

by ASIA United Bank, Davao City;

That the aforesaid Automated Teller Machine has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2014 at Davao City, Philippines
th

DERRICK UY
Affiant
SUBSCRIBED AND SWORN to before me this 30th day of October
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, PHILIP L. BAGALAY, of legal age, Filipino, and a resident of Km.
9 Talomo, Puan, Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD duly

issued by University of Mindanao, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2014 at Davao City, Philippines
th

PHILIP L. BAGALAY
Affiant

SUBSCRIBED AND SWORN to before me this 30th day of October

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MAE FATIMA LAGAS PONCE, of legal age, Filipino, and a
resident of 39-B Del Pilar St., Agdao, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD duly

issued by Davao Doctor’s College, Malvar St., Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

30 day of October 2014 at Davao City, Philippines
th

MAE FATIMA LAGAS PONCE

Affiant
Competent Proof of Identity:
Comelec ID VIN: 2402-0852B-B1784MLP20000

SUBSCRIBED AND SWORN to before me this 30th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, CANDIDO SAGUMIT ABRENICA of legal age, married, Filipino, a
resident of North Cotabato City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a ID duly issued by Philippine Health

Insurance Corporation (PHIC)

That the aforesaid ID has been inadvertently lost, dropped, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of October 2014 at Davao City, Philippines
th

CANDIDO SAGUMIT ABRENICA

Affiant
Competent Proof of Identity:
_______________________________

SUBSCRIBED AND SWORN to before me this 29th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, PEDRO C. MONTOYA, of legal age, single, Filipino, a resident of
Kawayan Drive, Matina, Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am a holder of a PAWN PAPER duly issued by the ROS-VER

Pawnshop Inc. Ilustre Branch City of Davao;

That the aforesaid PAWN PAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28 day of October 2014 at Davao City, Philippines
th

PEDRO C. MONTOYA
Affiant
Competent Proof of Identity:
TIN: 944-375-502

SUBSCRIBED AND SWORN to before me this 28th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, AQUILINO CUAJAO VALLESCAR JR., of legal age, single, Filipino,
a resident of Brgy. Sto. Niño, Talaingog, Davao Del Norte, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am a holder of an PAPCIFIC IDENTIFICATION CARD duly

issued by the Arm Forces of the Philippines (AFP), Tanay Rizal;

That the aforesaid PAPCIFIC IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

27 day of October 2014 at Davao City, Philippines
th

AQUILINO CUAJAO VALLESCAR JR.

Affiant

SUBSCRIBED AND SWORN to before me this 27th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MARK ANTHONY RAMIRES MADAYAN of legal age, married,
Filipino, and a resident of Prk 10 Bunawan Dist. Mahayag, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am a holder of an OR & CR No. 6088225-3 duly issued by

the Land Transportation Office (LTO) of Davao for an XRM Motorcycle
with the following details:
MAKE /TYPE/BODY : HONDA MOTORCYCLE
SERIES : XRM 125
PLATE NO. : 8990LC
MOTOR NO. : XRM14E048341
CHASSIS NO. : XRM14048372

That the aforesaid OR & CR No. 6088225-3 has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

27 day of October 2014 at Davao City, Philippines
th

MARK ANTHONY RAMIRES MADAYAN

Affiant
Competent Proof of Identity:
Driver’s License ID NO.: L04-07-005776

SUBSCRIBED AND SWORN to before me this 27th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, JENNY VEBB CANDIA HERMOSO, of legal age, single, Filipino, a
resident of Blk 5 Lot 31, NHA Agdao, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am a holder of a SOLICITATION FORM with serial No.

16539 duly issued by the Holy Cross of Davao College Inc,.

That the aforesaid SOLICITATION FORM has been inadvertently

lost, dropped, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

27 day of October 2014 at Davao City, Philippines
th

JENNY VEBB CANDIA HERMOSO

Affiant
Competent Proof of Identity:
School ID No. 45539061

SUBSCRIBED AND SWORN to before me this 27th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, PEDRO C. MONTOYA, of legal age, single, Filipino, a resident of
Kawayan Drive, Matina, Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINCE (ATM)

CARD duly issued by the Landbank of the Philippines, C.M. Recto Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINCE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of October 2014 at Davao City, Philippines
th

PEDRO C. MONTOYA
Affiant

SUBSCRIBED AND SWORN to before me this 24th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

That I am a holder of an AUTOMATED TELLER MACHINCE (ATM)

CARD duly issued by the Landbank of the Philippines, C.M. Recto Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINCE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of October 2014 at Davao City, Philippines
th

PEDRO C. MONTOYA
Affiant

SUBSCRIBED AND SWORN to before me this 24th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, GINN M. MANGLICMOT, of legal age, single, Filipino, a resident
of #180 Amethyst St., Morales Village, Matina, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am a holder of a CERTIFICATE OF HONORABLE

DISMISSAL duly issued by Holy Cross of Davao College;

That the aforesaid CERTIFICATE OF HONORABLE DISMISSAL has

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of October 2014 at Davao City, Philippines
th
GINN M. MANGLICMOT
Affiant
Competent Proof of Identity:
Postal ID No.: 3646539

SUBSCRIBED AND SWORN to before me this 24th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

\
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JANENE JAYMAEMA P. JAMORA, of legal age, single, Filipino, a
resident of Purok 7, Brgy. Bayabas, Toril, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am a holder of a PRC IDENTIFICATION CARD duly issued by

the Professional Regulation Commission (PRC);

That the aforesaid PRC IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of October 2014 at Davao City, Philippines
th
JANENE JAYMAEMA P. JAMORA
Affiant

SUBSCRIBED AND SWORN to before me this 24th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JELYN M. TABLADILLO, of legal age, single, Filipino, a resident of
Jacinto, Piapi, Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am a holder of a PASSPORT duly issued by the Department

of Foreign Affairs, Davao City;

That the aforesaid PASSPORT has been inadvertently lost,

dropped, or missing from my possession last October 20, 2014, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

24 day of October 2014 at Davao City, Philippines
th

JELYN M. TABLADILLO
Affiant

SUBSCRIBED AND SWORN to before me this 24th day of October

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DAVE RYAN L. CAÑETE, of legal age, single, Filipino, a resident
of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am a holder of a SCHOOL IDENTIFICATION CARD (ID) duly

issued by DMMA, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD (ID) has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of October 2014 at Davao City, Philippines
rd

DAVE RYAN L. CAÑETE

Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, PRETZEL DERECHO REGALADO, of legal age, married, Filipino,
a resident of Catalunan Grande, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a PASSPORT duly issued by the

Department of Foreign Affairs, Davao City;

That the aforesaid PASSPORT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of October 2014 at Davao City, Philippines

PRETZEL DERECHO REGALADO

Affiant
Competent Proof of Identity:
SSS ID No.: 09-1586286-7

SUBSCRIBED AND SWORN to before me this 23rd day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, GENEVIVE DALAGAN RAGOSTA, of legal age, single, Filipino, a
resident of Catalunan Grande, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a CLAIM STUB AND RECEIPT for my PRC

LICENSE duly issued by the PRC;

That the aforesaid CLAIM STUB AND RECEIPT has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of October 2014 at Davao City, Philippines
rd

GENEVIVE DALAGAN RAGOSTA

Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JECEIL ROSS LUPIAN DELA PEÑA, of legal age, single, Filipino, a
resident of Catalunan Grande, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a LAY-AWAY FORM duly issued by the

Agencia Kimsan, San Pedro Branch, Davao City;

That the aforesaid LAY-AWAY FORM has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of October 2014 at Davao City, Philippines

JECEIL ROSS LUPIAN DELA PEÑA

Affiant
Competent Proof of Identity:
PNP ID No.: 14G040161

SUBSCRIBED AND SWORN to before me this 23rd day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, EMMA ENRIQUEZ DELGADO, of legal age, married, Filipino, a
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a BUSINESS PLATE of Chadel

Documentation and Consultation Center with Business Permit No. B-
79663-3 and Business ID 2007-56206-5 duly issued by the Business
Bureau of Davao City;

That the aforesaid BUSINESS PLATE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of October 2014 at Davao City, Philippines

EMMA ENRIQUEZ DELGADO

Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, VENDRICK A. HUMOL, of legal age, single, Filipino, a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of DIPLOMA duly issued by Davao Medical

School Foundation (DMSF);

That the aforesaid DIPLOMA has been inadvertently lost, dropped,

or missing from my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21 day of October 2014 at Davao City, Philippines
st

VENDRICK A. HUMOL
Affiant

SUBSCRIBED AND SWORN to before me this 21st day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, RENAN L. SALADAR SR., of legal age, married, Filipino, a
resident of Bolton Isla, Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am the holder of an COMPANY IDENTIFICATION CARD duly

issued by SUMIFRU (Philippines) Corporation;

That the aforesaid COMPANY IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21st day of October 2014 at Davao City, Philippines
RENAN L. SALADAR SR.
Affiant
Competent Proof of Identity:
LTO License No.: L02-90-065212

SUBSCRIBED AND SWORN to before me this 21st day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DANIEL GAVIOLA SEDENTARIO, of legal age, married, Filipino, a
resident of Purok 6 Crossing Tagakpan, Tugbok District, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of an SSS IDENTIFICATION CARD duly issued

by the SSS;

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

21st day of October 2014 at Davao City, Philippines

DANIEL GAVIOLA SEDENTARIO

Affiant
Competent Proof of Identity:
LTO License No.: L02-90-065212
SUBSCRIBED AND SWORN to before me this 21st day of October
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, RODORA DELA CRUZ INSON, of legal age, married, Filipino, a
resident of Cecilia Phase 2, Cabantian, Buhangin, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office of Davao;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of October 2014 at Davao City, Philippines

RODORA DELA CRUZ INSON

Affiant
Competent Proof of Identity:
SSS ID No.: 03-9817919-9
SUBSCRIBED AND SWORN to before me this 20th day of October
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ANALYN RIVERA CHAVEZ, of legal age, single, Filipino, a
resident of 2 Silver St., Mineral Village, Bajada, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a FORM 138 duly issued by the Davao City
National High Scool;

That the aforesaid FORM 138 has been inadvertently lost, dropped,
or missing from my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of October 2014 at Davao City, Philippines
th

ANALYN RIVERA CHAVEZ

Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-011-3041979-3

SUBSCRIBED AND SWORN to before me this 20th day of October

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, LOUIGI BENCH L. NATAD, of legal age, single, Filipino, a resident
of Mabini, Compostella Valley, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD duly

issued by the Davao Merchant Marine Academy;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20th day of October 2014 at Davao City, Philippines

LOUIGI BENCH L. NATAD

Affiant

SUBSCRIBED AND SWORN to before me this 20th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, KRISTEL MARIE SUAREZ CAJES, of legal age, single, Filipino, a
resident of Pioneer St., Fortune Homes, Lanang, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a CLAIM STUB for my Red Ribbon

document duly issued by University of the Immaculate Conception,
Bankerohan Campus, Davao City;

That the aforesaid CLAIM STUB has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

20 day of October 2014 at Davao City, Philippines
th

KRISTEL MARIE SUAREZ CAJES

Affiant
Competent Proof of Identity:
PRC No.: 0058071

SUBSCRIBED AND SWORN to before me this 20th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2014. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, EDSEL C. VICADA, of legal age, married, Filipino, a resident of
Blk 1, Purok 14, Panacan Relocation, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of the following documents:

Driver’s License
SSS Card
PhilHealth Card
PRC License
TIN Card
DFA Passport Claim Stub

duly issued by their respective agencies;

That the aforesaid Driver’s License, SSS Card, PhilHealth Card,

PRC License, TIN Card, and DFA Passport Claim Stub, have been
inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering them, the same could no longer
be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of October 2014 at Davao City, Philippines
th

EDSEL C. VICADA
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, JAYSON POSTANES DIZON, of legal age, single, Filipino, a
resident of El Rio Vista, Davao City, Philippines, after having been duly
sworn to in accordance with law do hereby depose and state:

That I am the holder of a PAWN PAPER for 1 unit Samsung

Notebook duly issued by Rosver Pawnshop, Legaspi Branch, Davao City;

That the aforesaid PAWN PAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17th day of October 2014 at Davao City, Philippines

JAYSON POSTANES DIZON

Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALLAN S. ALGABRE, of legal age, Filipino, a resident of Davao City,

Philippines, after having been duly sworn to in accordance with law do hereby
depose and state:

That I am the owner of VALSTON CONSTRUCTION SUPPLY located at Prk. 5

De Agua Balengaeng, Tugbok, Davao City;
That I was issued a PHILHEALTH OFFICIAL RECEIPT JANUARY 2012
with OR no. C12030226410155 dated March 2, 2012 with the amount of
Php900.00 and MAY 2012 with OR no. C12062226350028 dated June 22,
2012 with the amount Php725.00 duly issued by UCPB Bank, Palma Gil
Branch, Davao City ;

That the aforesaid PHILHEALTH OFFICIAL RECEIPT JANUARY 2012

with OR no. C12030226410155 dated March 2, 2012 with the amount of
Php900.00 and MAY 2012 with OR no. C12062226350028 dated June 22,
2012 with the amount Php725.00 has been inadvertently lost or missing
from my possession when we transfer to another house and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17th day of October 2014 at Davao City, Philippines

ALLAN S. ALGABRE
Affiant
VIN 2402-3556B-A23991LGF20000

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEOVELYN GUILOREZA FERNANDEZ, of legal age, single,

Filipino, a resident of Prk 23, Santo Niño, Mintal, Tugbok Dist., Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:
That I am the holder of an PHILIPPINE PASSPORT duly issued by
Department of Foreign Affairs of Davao City ;

That last November 2013 the aforesaid PHILIPPINE PASSPORT

has been inadvertently lost or missing from my possession when we
transfer to another house and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17th day of October 2014 at Davao City, Philippines

LEOVELYN GUILOREZA FERNANDEZ

Affiant
VIN 2402-3556B-A23991LGF20000

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SUSAN E. GUMAUA, of legal age, married, Filipino, a resident of

Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of an AFPMBAI POLICY CONTRACT NO.

94020507 duly issued by Armed Forces and Police Mutual Benefit
Association, inc., Davao City;
That the aforesaid AFPMBAI POLICY CONTRACT NO. 94020507
has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of October 2014 at Davao City, Philippines
th

SUSAN E. GUMAUA
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROCHELLE B. LANDINGIN, of legal age, married, Filipino, a

resident of Sasa, Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the Mother of ROLAND GREG B. LANDINGIN 14 years

old;

That my son was issued a LIBRARY BORROWERS CARD duly

issued by the Holy Cross of Sasa College, Davao City;

That the aforesaid LIBRARY BORROWERS CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17 day of October 2014 at Davao City, Philippines
th

ROCHELLE B. LANDINGIN
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MICAH B. VILLARTA, of legal age, single, Filipino, a resident of

Cabantian Country Homes, Buhangin, Davao City, Philippines, after having
been duly sworn to in accordance with law do hereby depose and state:

That I am the holder of an CROSS YEARBOOK SOLICITATION

FORM with Provisional Receipt No. 07565 duly issued by the Holy
Cross of Davao College, Davao City;

That the aforesaid CROSS YEARBOOK SOLICITATION FORM has

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I will be requesting a replacement for the said CROSS

YEARBOOK SOLICITATION FORM;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
17th day of October 2014 at Davao City, Philippines

MICAH B. VILLARTA
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NOLI J. MARBAS JR., of legal age, single, Filipino, a resident of 39

Sto. Niño, Gotamco, Agdao, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD under Account No. 127350005958 duly issued by the Robinson
Bank, Sta. Ana Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of October 2014 at Davao City, Philippines

NOLI J. MARBAS JR.

Affiant
SUBSCRIBED AND SWORN to before me this 16th day of October
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, BASSAM CAMAMARA MAMALUBA, of legal age, married,

Filipino, a resident of Uyanguren, Tigatto, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (LTO) of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

17th day of October 2014 at Davao City, Philippines

BASSAM CAMAMARA MAMALUBA

Affiant

SUBSCRIBED AND SWORN to before me this 17th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DAN RAY M. DIAZ, of legal age, single, Filipino, a resident of

Manggahan, Toril, Davao City, Philippines, after having been duly sworn to
in accordance with law do hereby depose and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD under Account No. 0046-619379-100 duly issued by the
Philippine Verteran Bank, Monteverde Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of October 2014 at Davao City, Philippines

DAN RAY M. DIAZ

Affiant
Competent Proof of Identity:
PRC Registration No.: 1203518

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSE A. ALBALADEJO, of legal age, married, Filipino, a resident

of Purok San Nicolas, Manggahan St., Buhangin, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a ST. PETER LIFE PLAN POLICY with

Policy No. L12307597P duly issued by the St. Peter Life Plan, Inc.;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of October 2014 at Davao City, Philippines
th

JOSE A. ALBALADEJO
Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0010-0030123-2

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PRINCESS ANGEL M. LAPAYAG, of legal age, single, Filipino, a

resident of Purok 2, Manay, Panabo City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT with Passport

No. W0942242 duly issued by the Department of Foreign Affairs, Davao
City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost, dropped, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of October 2014 at Davao City, Philippines

PRINCESS ANGEL M. LAPAYAG

Affiant

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, LEONILO R. HILAY, of legal age, married, Filipino, a resident of
Maa, Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the authorized of MATRANSCO and that they issued a

VEHICLE PLATE NO.LAL192 duly issued by Land Transportation Office,
Davao City;

That the aforesaid VEHICLE PLATE NO.LAL192 has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of October 2014 at Davao City, Philippines
th

LEONILO R. HILAY
Affiant

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ROBERTO A. MAGDAÑGAL, of legal age, married, Filipino, a
resident of Mintal Relocation, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:
That I am the holder of an AUTOMATED TELLER MACHINE (ATM)
CARD duly issued by Land Bank of the Philippines, Matina GSIS Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of October 2014 at Davao City, Philippines
th

ROBERTO A. MAGDAÑGAL
Affiant
Competent Proof of Identity:
OSCA (Makati) ID No.: 19210

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, EDMON G. BAUTISTA, of legal age, married, Filipino, a resident
of Davao City, Philippines, after having been duly sworn to in accordance
with law do hereby depose and state:

That I am the holder of PASSBOOK duly issued by Armed Forces

and Police Savings & Loan Association, Inc (AFPSLAI), Davao City;
That the aforesaid PASSBOOK has been inadvertently lost,
dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of October 2014 at Davao City, Philippines
th

EDMON G. BAUTISTA
Affiant
Competent Proof of Identity:
AFPSLAI ID No.: 121324

SUBSCRIBED AND SWORN to before me this 16th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, DANILO T. OMANDAC JR., of legal age, single, Filipino, a
resident of Ilang River Side, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a COMPANY IDENTIFICATION CARD duly

issued by Gaisano Grand Mall, Tibungco, Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD has been

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14th day of October 2014 at Davao City, Philippines

DANILO T. OMANDAC JR.

Affiant

SUBSCRIBED AND SWORN to before me this 14th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, CHAESSAN ENDRINA EMPERADO, of legal age, single, Filipino,
a resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PAWN PAPER under #66509 for 1 unit

Samsung Notebook duly issued by Monte de Oro Pawnshop, Acacia
Branch, Davao City;

That the aforesaid PAWN PAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
14 day of October 2014 at Davao City, Philippines
th

CHAESSAN ENDRINA EMPERADO

Affiant

SUBSCRIBED AND SWORN to before me this 14th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, CHERREL DUBLUIS MAMERTO, of legal age, Filipino, a resident
of Compostela Valley, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT with PASSPORT

No. XX0960404 duly issued by the Department of Foreign Affairs (DFA)
of Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost from my possession last 2013 due to floods caused by typhoon Pablo,
and despite of diligent efforts to locating and recovering it, the same
could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

14 day of October 2014 at Davao City, Philippines
th
CHERREL DUBLUIS MAMERTO
Affiant
Competent Proof of Identity:
Comelec ID VIN: 8201-0153A-K2384CMP20000

SUBSCRIBED AND SWORN to before me this 14th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CLAIRE YBAÑEZ FUENTES, of legal age, single, Filipino, a

resident of B-44 Lot 6 Deca Homes, Tigatto, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a PHILIPPINE PASSPORT with PASSPORT

no. EB2108839 duly issued by the DFA Cagayan De Oro City;

That the aforesaid PHILIPPINE PASSPORT with PASSPORT no.

EB2108839 has been inadvertently lost, dropped, or missing from his
possession, and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of October 2014 at Davao City, Philippines
th

CLAIRE YBAÑEZ FUENTES

Affiant
Competent Proof of Identity:
Passport no.EB2108839
SUBSCRIBED AND SWORN to before me this 10th day of October
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, REMIE MICABANI AURELIO JR., of legal age, married, Filipino, a

resident of Davao City, Philippines, and accounting staff of XTREME Cargo
Logistics Corp., after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a FORM 1901 duly issued by the Bureau of

Internal Revenue (BIR) of Davao City;

That the aforesaid FORM 1901 has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of October 2014 at Davao City, Philippines

REMIE MICABANI AURELIO JR.

Affiant
Competent Proof of Identity:
TIN: 311-781-700-000

SUBSCRIBED AND SWORN to before me this 10th day of October

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARYLOU C. RAOTRAOT, of legal age, Filipino, a resident of

Davao City, Philippines, and accounting staff of XTREME Cargo Logistics
Corp., after having been duly sworn to in accordance with law do hereby
depose and state:

That I am the holder of a PINK DELIVERY RECEIPT with DR No.

191162 duly issued by Mindanao Corrugated FibreBoard, Inc.;

That the aforesaid PINK DELIVERY RECEIPT has been

inadvertently lost from my possession at Mandaue, Cebu, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of October 2014 at Davao City, Philippines

MARYLOU C. RAOTRAOT
Affiant
Competent Proof of Identity:
SSS No.: 0935140420

SUBSCRIBED AND SWORN to before me this 10th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEO A. VALLE III, of legal age, Filipino, and a resident of Lot 2 Blk
2 Landmark 2, Sasa Km. 11, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a PAWNPAPER for a Samsung Galaxy Tab 2

10.0” duly issued by the Rosver Pawnshop, Sasa Branch;

That the aforesaid PAWNPAPER has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10th day of October 2014 at Davao City, Philippines

LEO A. VALLE III

Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-2916147-6

SUBSCRIBED AND SWORN to before me this 10th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, CATHERINE CAGATA OCMEJA, of legal age, Filipino, and a

resident of Bajada, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of an COMPANY IDENTIFICATION CARD duly

issued by the Pritong Manok;

That the aforesaid COMPANY IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

10 day of October 2014 at Davao City, Philippines
th

CATHERINE CAGATA OCMEJA

Affiant
Competent Proof of Identity:
PhilHealth No.: 16-025465645-0

SUBSCRIBED AND SWORN to before me this 10th day of October

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, RAFAELA S. GO, of legal age, Filipino, and a resident of

Tanchontian, Brgy. Duterte , Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the holder of a TIN CARD duly issued by the Bureau of

Internal Revenue;

That the aforesaid TIN CARD has been inadvertently lost, dropped,
or missing from his possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of October 2014 at Davao City, Philippines

RAFAELA S. GO
Affiant

SUBSCRIBED AND SWORN to before me this 8th day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, SHIELA MAE E. PANO, of legal age, single, Filipino, and a
resident of Bolton, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the widow holder of an AUTOMATED TELLER MACHINE

CARD duly issued by Banco de Oro, SM City Davao Branch, Davao under
Savings Account No. 860590240;

That the aforesaid AUTOMATED TELLER MACHINE CARD has

been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of October 2014 at Davao City, Philippines

SHIELA MAE E. PANO

Affiant
Competent Proof of Identity:
PRC ID No.: 0492936

SUBSCRIBED AND SWORN to before me this 8th day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GIMAR A. LICAYAN, of legal age, married, Filipino, and a

resident of Shrine Hills, Matina, Davao City, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

That I am the widow holder of an SECURITY LICENSE duly issued

by Makabayan Security Agency;
That the aforesaid SECURITY LICENSE has been inadvertently lost,
dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of October 2014 at Davao City, Philippines

GIMAR A. LICAYAN
Affiant
Competent Proof of Identity:
LTO License No.: L02-13-003174

SUBSCRIBED AND SWORN to before me this 8th day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROGIE JOHN B. ASPILLA, of legal age, single, Filipino, and a

resident of Bolton, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the widow holder of an AUTOMATED TELLER MACHINE

CARD duly issued by Union Bank, Rizal Branch, Davao City under account
number 109490987710;

That the aforesaid AUTOMATED TELLER MACHINE CARD has

been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of October 2014 at Davao City, Philippines

ROGIE JOHN B. ASPILLA

Affiant
Competent Proof of Identity:
UM-P ID No.: CRN-0111-1847225-7

SUBSCRIBED AND SWORN to before me this 8th day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MERLINDA ARENDAIN ORTILANO, of legal age, widow, Filipino,

and a resident of Km. 11 Purok 8, Cabantian, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the widow of the late, DANIEL ARANDILLA ORTILANO,

holder and owner of an AUTOMATED TELLER MACHINE CARD duly
issued by Philippine National Bank (PNB), C.M. Recto Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE CARD has

been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th

day of October 2014 at Davao City, Philippines
MERLINDA ARENDAIN ORTILANO
Affiant
Competent Proof of Identity:
Comelec VIN: 2402-1805A-B0266MAO20000

SUBSCRIBED AND SWORN to before me this 7th day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ARTEMIO S. BATILLER, of legal age, married, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law do hereby depose and state:

That I am the holder of a CERTIFICATE OF REGISTRATION duly

issued by the Bureau of Internal Revenue, Davao City;

That the aforesaid CERTIFICATE OF REGISTRATION has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of October 2014 at Davao City, Philippines

ARTEMIO S. BATILLER
Affiant
Competent Proof of Identity:
SSS No.: 09-2310044-3

SUBSCRIBED AND SWORN to before me this 3rd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHRYSTELLE JAN ABALLE OREIRO, of legal age, single, Filipino,

and a resident of Marfori 2, 067B Eagle St., Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of a PAWN TICKET with the following details:

Code : 1275
Unit : iPad 2
Serial No. : XDKPH
Date Pawned : August 27, 2014
Expiry Date : September 27, 2014

duly issued by the Sanlaan ng Bayan, Bolton Branch, Davao City;

That the aforesaid PAWN TICKET has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of October 2014 at Davao City, Philippines
CHRYSTELLE JAN ABALLE OREIRO
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, AIZA MAE O. VASQUEZ, of legal age, single, Filipino, and a

resident of Lasang, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a HEALTH CARD duly issued by the City

Health Office of Davao City;

That the aforesaid HEALTH CARD has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of October 2014 at Davao City, Philippines

AIZA MAE O. VASQUEZ

Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, AIZA MAE O. VASQUEZ, of legal age, single, Filipino, and a

resident of Lasang, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a HEALTH CARD duly issued by the City

Health Office of Davao City;

That the aforesaid HEALTH CARD has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of October 2014 at Davao City, Philippines

AIZA MAE O. VASQUEZ

Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JULIE D. MEDROCILLO, of legal age, single, Filipino, and a

resident of South Villa Heights, Catalunan Grande, Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a PAWN PAPER under Receipt No. 0035-

2014-00154 with the amount of P1950.00 for a Pair of Earrings, duly
issued by M Lhuiller, Catalunan Grande Branch, Davao City;

That the aforesaid PAWN PAPER has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of October 2014 at Davao City, Philippines

JULIE D. MEDROCILLO
Affiant
Competent Proof of Identity:
UM-P ID: CRN-0004-1637558-1

SUBSCRIBED AND SWORN to before me this 3rd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ANA ROSE B. ABORDO, of legal age, widow, Filipino, and a
resident of Sitio Awa, Bagong Pag-asa, Catalunan Grande, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I my late husband was the holder of a LIFE PLAN CONTRACT

under his name, JERRY L. ABORDO, plan type St. Hyacinth, and contract
number 05421250C, duly issued by St. Peter Life Plans Inc.;

That the aforesaid LIFE PLAN CONTRACT has been inadvertently

lost, dropped, or missing from his possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of October 2014 at Davao City, Philippines

ANA ROSE B. ABORDO

Affiant
Competent Proof of Identity:
PRC No.: 0058071

SUBSCRIBED AND SWORN to before me this 2nd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KRISTEL MARIE S. CAJES, of legal age, single, Filipino, and a

resident of Purok 6-C, Poblacion, New Corella, Davao del Norte,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:
That I am the holder of a BOARD CERTIFICATE duly issued by the
Professional Regulation Commission;

That the aforesaid BOARD CERTIFICATE has been inadvertently

lost, dropped, or missing from his possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of October 2014 at Davao City, Philippines

KRISTEL MARIE S. CAJES

Affiant
Competent Proof of Identity:
PRC No.: 0058071

SUBSCRIBED AND SWORN to before me this 2nd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KRISTEL MARIE S. CAJES, of legal age, single, Filipino, and a

resident of Purok 6-C, Poblacion, New Corella, Davao del Norte,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of a BOARD CERTIFICATE duly issued by the

Professional Regulation Commission;

That the aforesaid BOARD CERTIFICATE has been inadvertently

lost, dropped, or missing from his possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of October 2014 at Davao City, Philippines

KRISTEL MARIE S. CAJES

Affiant
Competent Proof of Identity:
PRC No.: 0058071

SUBSCRIBED AND SWORN to before me this 2nd day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RUD VINCENT V. VILLALUZ, of legal age, single, Filipino, and a

resident of Panacan, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of an SCHOOL IDENTIFICATION CARD duly

issued by the University of Immaculate Concepcion, Bonifacio, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st
day of October 2014 at Davao City, Philippines

RUD VINCENT V. VILLALUZ

Affiant

SUBSCRIBED AND SWORN to before me this 1st day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CELESTE GABRIEL REY, of legal age, single, Filipino, and a

resident of 168 Gardenia St., San Pedro Village, Buhangin, Davao City,
Philippines, after having been duly sworn to in accordance with law do
hereby depose and state:

That I am the holder of an ACKNOWLEDGMENT RECEIPT with

NUMBER D11738 issued on SEPTEMBER 3, 2014 duly issued by the
Apple Service Center at Abreeza Mall of Davao City;

That the aforesaid ACKNOWLEDGMENT RECEIPT has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2014 at Davao City, Philippines
CELESTE GABRIEL REY
Affiant
Competent Proof Identity:
LTO License No.: L02-09-004443

SUBSCRIBED AND SWORN to before me this 1st day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JANICE S. YLAYA, of legal age, single, Filipino, and a resident of

San Miguel, Agdao, Davao City, Philippines, after having been duly sworn
to in accordance with law do hereby depose and state:

That I am the holder of a TAX IDENTIFICATION NUMBER (TIN)

CARD under TIN NUMBER 409-770-483-000 duly issued by the Bureau
of Internal Revenue (BIR) of Davao City;

That the aforesaid TAX IDENTIFICATION NUMBER (TIN) CARD

has been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2014 at Davao City, Philippines

JANICE S. YLAYA
Affiant

SUBSCRIBED AND SWORN to before me this 1st day of October 2014

at Davao City, Philippines
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2014. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHARIE GERONA CAYUNDA, of legal age, single, Filipino, and a

resident of 396-11 Sesame Alley, Bonifacio St., Davao City, Philippines,
after having been duly sworn to in accordance with law do hereby depose
and state:

That I am the holder of a TAX IDENTIFICATION NUMBER (TIN)

CARD duly issued by the Bureau of Internal Revenue (BIR) of Davao City;

That the aforesaid TAX IDENTIFICATION NUMBER (TIN) CARD

has been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of October 2014 at Davao City, Philippines

CHARIE GERONA CAYUNDA

Affiant

SUBSCRIBED AND SWORN to before me this 1st day of October 2014

at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIO ABE YAÑEZ, of legal age, single, Japanese Citizen, and a

resident of Purok Durian, Tagakpan Tugbok, Davao City, Philippines, after
having been duly sworn to in accordance with law do hereby depose and
state:

That I am the holder of an Regular Time Deposit under Account

No. 314940542000015 with the amount of FOURTEEN THOUSAND
TWO HUNDRED NINETY FIVE AND SIXTY CENTAVO (14, 295.60)
duly issued by the Philippine National Bank, Bangoy City of Davao Branch;

That the aforesaid Regular Time Deposit has been inadvertently

lost, dropped, or missing from his possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29th day of September 2014 at Davao City, Philippines

MARIO ABE YAÑEZ

Affiant
Competent Proof Identity:
Passport Bearing No. EB4339686

SUBSCRIBED AND SWORN to before me this 29th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, REMEDIOS A. BENECARIO, of legal age, married, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of an E-CARD duly issued by the GSIS;

That the aforesaid E-CARD has been inadvertently lost, dropped, or

missing from his possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

29 day of September 2014 at Davao City, Philippines
th

REMEDIOS A. BENECARIO
Affiant
Competent Proof of Identity:
OSCA ID No.: 13-007525

SUBSCRIBED AND SWORN to before me this 29th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, LIONEL L. DELA CRUZ, of legal age, Filipino, and a resident of
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a POLICY CONTRACT with number

L12159530P duly issued by the St. Peter Life Plan;

That the aforesaid POLICY CONTRACT has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26th day of September 2014 at Davao City, Philippines

LIONEL L. DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me this 26th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GRACE C. BAES, of legal age, Filipino, and a resident of Davao

City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of a POLICY CONTRACT with number

L12159531P duly issued by the St. Peter Life Plan;
That the aforesaid POLICY CONTRACT has been inadvertently lost,
dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of September 2014 at Davao City, Philippines
th

GRACE C. BAES
Affiant

SUBSCRIBED AND SWORN to before me this 26th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, BJORN HARDY LLOYD VILLAGONZALO EDING, of legal age,

Filipino, and a resident of #4 Road 3, Doña Vicenta Village 2, Bajada,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a TAX IDENTIFICATION NUMBER (TIN)

CARD duly issued by the Bureau of Internal Revenue;

That the aforesaid TAX IDENTIFICATION NUMBER (TIN) CARD

has been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26th day of September 2014 at Davao City, Philippines

BJORN HARDY LLOYD VILLAGONZALO EDING

Affiant
Competent Proof of Identity:
UM-P ID: CRN-0111-2779862-1

SUBSCRIBED AND SWORN to before me this 26th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY JANE B. BOLANDO, of legal age, Filipino, and a resident

of Barobo, Surigao del Sur, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a PAYSLIP for the month of August duly

issued by the Ma-a National High School;

That the aforesaid PAYSLIP has been inadvertently lost, dropped,

or missing from his possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26th day of September 2014 at Davao City, Philippines
MARY JANE B. BOLANDO
Affiant

SUBSCRIBED AND SWORN to before me this 26th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHARISSE GO RONQUILLO, of legal age, Filipino, and a resident

of Barobo, Surigao del Sur, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of an OFFICIAL RECEIPT with P.R.# 2083

and O.R.# 338 duly issued by the Green Sphere Realty Corporation;

That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

26 day of September 2014 at Davao City, Philippines
th

CHARISSE GO RONQUILLO
Affiant
Competent Proof of Identity:
SSS No.: 09-2769168-6
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 26th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JERLYN S. ARENDUQUE, of legal age, single, Filipino, and a

resident of Bagong Silang, Gredu, Panabo City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by

the Department of Foreign Affairs;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost when our place was hit by a flood last August of 2011 and despite of
diligent efforts of recovering it, the same could no longer be found hence,
I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of September 2014 at Davao City, Philippines

JERLYN S. ARENDUQUE
Affiant
Competent Proof of Identity:
Postal ID No.: __________________________
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 22nd day of September

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RONALD J. FRANCISCO, of legal age, married, Filipino, and a

resident of Blk 10 Lot 15, Samantha Homes, Catalunan Pequeño, Davao
City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of a COMPANY IDENTIFICATION CARD duly

issued by the LTS Pinnacle Holdings, Inc., NHQ Bldg., Gempesaw St.,
Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of September 2014 at Davao City, Philippines

RONALD J. FRANCISCO
Affiant
Competent Proof of Identity:
CTC No.: 01724965
Competent Proof of Identity:
OSCA ID No.: 500
SUBSCRIBED AND SWORN to before me this 22nd day of September
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Roll of Attorney’s No. 54826
Series of 2014. PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GERALDINE ZAMORA TAGOSE, of legal age, Filipino, and a

resident of Blk 3 Lot 16 Purok 8, Upper Catitipan, Insel Subd., Buhangin,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a TIN CARD with number 308-064-057-

000 duly issued by the Bureau of Internal Revenue (BIR), Davao City;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of September 2014 at Davao City, Philippines

GERALDINE ZAMORA TAGOSE

Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 22nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, RIZA TAMBIS MINORO, of legal age, Filipino, and a resident of

New Cortez, New Corella, Davao del Norte, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a TIN CARD with number 435-828-954-

000 duly issued by the Bureau of Internal Revenue (BIR), Davao City;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22nd day of September 2014 at Davao City, Philippines

RIZA TAMBIS MINORO

Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 22nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, PATROCINIA JARABE JISON, of legal age, married, Filipino, and
a resident of Purok 12, Tibungco, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a SENIOR CITIZEN IDENTIFICARTION

CARD duly issued by the Office of the Senior Citizen Affairs (OSCA), Davao
City;

That the aforesaid SENIOR CITIZEN IDENTIFICARTION CARD has

been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of September 2014 at Davao City, Philippines

PATROCINIA JARABE JISON

Affiant
Competent Proof of Identity:
TIN: 296-716-927-000
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 22nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, BEATRIZ SAN JUAN, of legal age, married, Filipino, and a
resident of Brgy 21-C, Blk 93, Piapi, Boulevard, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of a PAWNPAPER duly issued by Cebuana

Lhuiller, Boulevard Branch, with the following details:
PT# 50418SG015458
Load Date : 07/16/14
Expiry Date : 11/14/14
Description : Pr. Earring
Amount : P2,900.00;

That the aforesaid PAWNPAPER has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of September 2014 at Davao City, Philippines

BEATRIZ SAN JUAN

Affiant
Competent Proof of Identity:
TIN: 296-716-927-000
Competent Proof of Identity:
OSCA ID No.: 50063
SUBSCRIBED AND SWORN to before me this 22nd day of September
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, DANAH GRACE S. ALAGON, of legal age, single, Filipino, and a

resident of 2105 Bangoy St., Panabo City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a WELCOME KIT (BLUE BOOK) duly issued

by the TELEPERFORMANCE, located at 4th Floor, SM Annex, Ecoland, Davao
City;

That the aforesaid WELCOME KIT (BLUE BOOK) has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

22 nd
day of September 2014 at Davao City, Philippines

DANAH GRACE S. ALAGON

Affiant
Competent Proof of Identity:
TIN: 296-716-927-000
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 22nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, KRISTEL MARIE S. CAJES, of legal age, single, Filipino, and a

resident of Purok 6-C, Poblacion, New Corella, Davao del Norte,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by

the Department of Foreign Affairs;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost when my apartment at Juan Luna-Aklan, Davao City was brought
down by a fire and despite of diligent efforts of recovering it, the same
could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
22 nd
day of September 2014 at Davao City, Philippines

KRISTEL MARIE S. CAJES

Affiant
Competent Proof of Identity:
PRC No.: 0058071
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 22nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, NIMFA P. MACO, of legal age, single, Filipino, and a resident of

Ma-a, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of SCHOOL IDENTIFICATION CARD duly

issued by the University of Mindanao under ID number 401359 for BS
Accountancy course;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of September 2014 at Davao City, Philippines
NIMFA P. MACO
Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 19th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DOMINADOR ESTRADA JR., of legal age, Filipino, married to

Adelina Estrada, and a resident of Fuentes, Pantukan, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of TRANSFER CERTIFICATE OF TITLE with

number P-28418 duly issued by the Registry of Deeds;

That the aforesaid TRANSFER CERTIFICATE OF TITLE has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

19th day of September 2014 at Davao City, Philippines

DOMINADOR ESTRADA JR.

Affiant
Competent Proof of Identity:
OSCA ID No.: 50063
SUBSCRIBED AND SWORN to before me this 19th day of September
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MADOLINE A. DELA ROSA, of legal age, widow, Filipino, and a

resident of Ruby St., St. Theresa Drive, RGA Agdao, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of CONTRACT AGREEMENT DOCUMENTS

from St. Peter Life Plan;

That the aforesaid CONTRACT AGREEMENT DOCUMENTS have

been inadvertently lost, dropped, or missing from his possession, and
despite of diligent efforts to locating and recovering them, the same could
no longer be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18th day of September 2014 at Davao City, Philippines

MADOLINE A. DELA ROSA

Affiant
Competent Proof of Identity:
OSCA ID No.: 94468
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 18th day of September

AFFIDAVIT OF LOSS

I, DENIS PODADOR CABASE, of legal age, single, Filipino, and a

resident of Bajada, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the holder of a TALK N’ TEXT SIMCARD with number

09099001707;

That the aforesaid SIMCARD has been inadvertently lost, dropped,

or missing from his possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18th day of September 2014 at Davao City, Philippines

DENIS PODADOR CABASE

Affiant
Competent Proof of Identity:
LTO License No.: L02-13-011129
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 18th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, EVELYN R. BERICO, of legal age, married, Filipino, a resident of
San Miguel, Tagum City, Philippines, and the authorized representative
of ERROL SIM T. HIQUIAL and EMMANIEL T. HIQUIAL, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an OFFICIAL RECEIPT for LANDBANK

PAYMENT dated JUNE 3, 2014 duly issued by the Land Bank of the
Philippines, San Pedro Branch and a FORM 2000-OT under the name of
ERROL SIM T. HIQUIAL ET AL duly issued by the Bureau of Internal
Revenue (B.I.R.) of Davao Branch 132;

That the aforesaid OFFICIAL RECEIPT and FORM 2000-OT have

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering them, the same could
no longer be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18th day of September 2014 at Davao City, Philippines

EVELYN R. BERICO
Affiant
Competent Proof of Identity:
TIN: 929-390-558-000

SUBSCRIBED AND SWORN to before me this 18th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2014. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS
I, EVELYN R. BERICO, of legal age, married, Filipino, a resident of
San Miguel, Tagum City, Philippines, and the authorized representative
of ERROL SIM T. HIQUIAL and EMMANIEL T. HIQUIAL, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an OFFICIAL RECEIPT for LANDBANK

That the aforesaid OFFICIAL RECEIPT and FORM 2000-OT have

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering them, the same could
no longer be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18 day of September 2014 at Davao City, Philippines
th

EVELYN R. BERICO
Affiant
Competent Proof of Identity:
TIN: 929-390-558-000

SUBSCRIBED AND SWORN to before me this 18th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, SINNY TINDOY DIAMPA, of legal age, single, Filipino, and a
resident of Piapi, Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am the holder of a PAYCARD from the METROBANK duly

issued by the my employer company, Gaisano Grand Citi Mall, Davao City;

That the aforesaid PAYCARD has been inadvertently lost, dropped,

or missing from his possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16th day of September 2014 at Davao City, Philippines

SINNY TINDOY DIAMPA

Affiant
Competent Proof of Identity:
TIN: 457-047-369
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 16th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, LUZVIMINDA A. LAENO, of legal age, married, Filipino, and a

resident of Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:
That I am the holder of a PASSBOOK under account number
307752100011 duly issued by the Philippine National Bank, C.M. Recto
Branch, Davao City;

That the aforesaid PASSBOOK has been inadvertently lost,

dropped, or missing from his possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

16 day of September 2014 at Davao City, Philippines
th

LUZVIMINDA A. LAENO
Affiant
Competent Proof of Identity:
Barangay Buhangin ID No.: 2720
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 16th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ADAN GEORGE B. DE LEON, of legal age, single, Filipino, and a

resident of Lumboy St., Niceville Subd., Panabo City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a MEDICARD duly issued by IBEX Global

and a CASH CARD under number 100658030170 duly issued by
Unionbank, Victoria Plaza Branch, Davao City;
That the aforesaid MEDICARD and CASH CARD have been
inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering them, the same could no longer
be found hence, we consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

12 day of September 2014 at Davao City, Philippines
th

ADAN GEORGE B. DE LEON

Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 12th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PRINCE JASON L. EMPERADO, 17 years old, single, Filipino, and

a resident of Bucana, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a SCHOOL IDENTIFICATION CARD with

number 397919 duly issued by the University of Mindanao (UM), Davao
City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, we consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11th day of September 2014 at Davao City, Philippines

PRINCE JASON L. EMPERADO

Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 11th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RICARDO L. ALIO JR., of legal age, single, Filipino, and a resident

of Ledesma, Marfori Heights, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a HEALTH CARD and COMPANY

IDENTIFICATION CARD duly issued by the PhilHealth of Davao and NCCC
LTS Supermarket, respectively;

That the aforesaid HEALTH CARD and COMPANY

IDENTIFICATION CARD have been inadvertently lost, dropped, or
missing from my possession, and despite of diligent efforts to locating and
recovering them, the same could no longer be found hence, I consider
them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of September 2014 at Davao City, Philippines
th
RICARDO L. ALIO JR.
Affiant

SUBSCRIBED AND SWORN to before me this 11th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DAHLIA I. VISTAR, of legal age, married, Filipino, and a resident

of #10 Garden Park, Bajada, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the mother of LEOCER JAY I. VISTAR, Grade 7 Student of

Davao City National High School (DCNHS); that my son is the holder of a
SCHOOL IDENTIFICATION CARD duly issued by the DCNHS, Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from his possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, we consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11th day of September 2014 at Davao City, Philippines

DAHLIA I. VISTAR
Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 11th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSE A. LUSTIVA, of legal age, single, Filipino, and a resident of

Malagos, Baguio District, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the PHILIPPINE NATIONAL BANK (PNB), Bankerohan
Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

11 day of September 2014 at Davao City, Philippines
th

JOSE A. LUSTIVA
Affiant
Competent Proof of Identity:
OSCA ID No.: 50063

SUBSCRIBED AND SWORN to before me this 11th day of September

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALMA L. UNDAG, of legal age, single, Filipino, and a resident of

GSIS Heights Matina, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the Robinsons Bank (Cybergate), Bajada Branch,
Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of September 2014 at Davao City, Philippines
th

ALMA L. UNDAG
Affiant
Competent Proof of Identity:
TIN: 940-046-777

SUBSCRIBED AND SWORN to before me this 23th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, LEO ONDONA EROY JR., of legal age, married, Filipino, and a

resident of Seaside Subd., Matina Aplaya, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of a LICENSE CARD duly issued by the Land

Transportation Office of Davao City;

That the aforesaid LICENSE CARD has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of September 2014 at Davao City, Philippines

LEO ONDONA EROY JR.

Affiant

SUBSCRIBED AND SWORN to before me this 4th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CLYDE F. MARTIN, of legal age, married, Filipino, and a resident

of Purok 1, Emerald St., Doña Salud Subd., Sasa, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD under ACCOUNT NUMBER 002-51-43358-7 duly issued by the
One Network Bank, San Perdo Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of September 2014 at Davao City, Philippines

CLYDE F. MARTIN
Affiant

SUBSCRIBED AND SWORN to before me this 9th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JESS O. BALDECAÑAS, of legal age, single, Filipino, and a
resident of Magallanes St., Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of a ST. PETER PLANHOLDER’S APPLICATION

FORM DOCUMENT duly issued by the St. Peter Life Plan Inc.;

That the aforesaid ST. PETER PLANHOLDER’S APPLICATION

FORM DOCUMENT6 has been inadvertently lost, dropped, or missing
from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

day of September 2014 at Davao City, Philippines

JESS O. BALDECAÑAS
Affiant

SUBSCRIBED AND SWORN to before me this 9th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOLLY RIZALDO GASMIN, of legal age, married, Filipino, and a

resident of Mintrade Drive, V. Pelayo, Brgy. Centro, Agdao, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:
That I am a holder of a SMART PINOY ROAMING SUBSCRIBER
IDENTITY MODULE (SIM) CARD with number 09989052370 duly
issued by Smart Communications, Phils.;

That the aforesaid SMART PINOY ROAMING SUBSCRIBER

IDENTITY MODULE (SIM) CARD has been inadvertently lost, dropped,
or missing from my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of September 2014 at Davao City, Philippines

JOLLY RIZALDO GASMIN

Affiant
Competent Proof of Identity:
PRC ID No.: 0036293

SUBSCRIBED AND SWORN to before me this 8th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ALEXIS L. ADILAN, of legal age, single, Filipino, and a resident of

Km. 12, Sasa, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am a holder of a DRIVER’S LICENSE (duly issued by the

Land Transportation Office of Davao City), COMPANY ID (duly issued by
FSTA Trucking Inc.), SSS ID (with number 09-2425871-8), and TIN CARD
(with number 939-291-441);

That the aforesaid DRIVER’S LICENSE, COMPANY ID, SSS ID,

and TIN CARD have been inadvertently lost, dropped, or missing from
my possession, and despite of diligent efforts to locating and recovering
them, the same could no longer be found hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of September 2014 at Davao City, Philippines

ALEXIS L. ADILAN
Affiant

SUBSCRIBED AND SWORN to before me this 8th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY ROSE SIMON DITUA, of legal age, single, Filipino, and a

resident of Toril, Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am a holder of a TIN CARD duly issued by the Bureau of

Internal Revenue;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of September 2014 at Davao City, Philippines
MARY ROSE SIMON DITUA
Affiant
Competent Proof of Identity:
PRC ID No.: 10271982

SUBSCRIBED AND SWORN to before me this 8th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSEPH RYAN S. SANCHEZ, of legal age, single, Filipino, and a

resident of Bread Village, Tigatto, Buhangin, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the Development Bank of the Philippines (DBP), C.M.
Recto Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of September 2014 at Davao City, Philippines

JOSEPH RYAN S. SANCHEZ

Affiant

SUBSCRIBED AND SWORN to before me this 8th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, NASSER L. CABAD, of legal age, single, Filipino, and a resident of

2 Pogi St., Nograles Avenue, Bucana, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the Development Bank of the Philippines (DBP), C.M.
Recto Branch, Davao City and a SCHOOL IDENTIFICATION CARD duly
issued by the DMMA-CSP;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

and SCHOOL IDENTIFICATION CARD have been inadvertently lost,
dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering them, the same could no longer be found hence, I
consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th

day of September 2014 at Davao City, Philippines

NASSER L. CABAD
Affiant

SUBSCRIBED AND SWORN to before me this 8th day of September

AFFIDAVIT OF LOSS
I, FRANCIS LONGAKIT BAYER, of legal age, single, Filipino, and a
resident of Zone 2, Dumanlas, Buhangin, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of an OFFICIAL RECEIPT of FIRE TRUCK

REGISTRATION for FILIPINO CHINESE FIRE FIGHTERS FOUNDATION
OF DAVAO INCORPORATED duly issued by the Land Transportation
Office (LTO) of Davao for an Isuzu Fire truck with the following details:
MAKE /TYPE/BODY : ISUZU
SERIES : New Fire Truck - Old Tank Lorry
PLATE NO. : T-PPR-118

That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines

FRANCIS LONGAKIT BAYER

Affiant
Competent Proof of Identity:
Driver’s License ID NO.: L02-11-009498

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALLAN MANZO AWITIN, of legal age, single, Filipino, and a

resident of Water Lily Village, Brgy. Aquino, Agdao, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am a holder of an INTEREST AND SAVINGS CAPITAL

PASSBOOK duly issued by the PHILIPPINE RESOURCES SAVINGS BANKING
CORPORATION;

That the aforesaid PASSBOOK has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines

ALLAN MANZO AWITIN

Affiant
Competent Proof of Identity:
Driver’s License ID NO.: L06-06-005160

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, ENERIE BERNOLO AQUINO, of legal age, widow, Filipino, and a

resident of 158 –A JP Cabaguio Ave, Agdao, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of a BUSINESS PLATE duly issued by the

Business Bureau of Davao City;

That the aforesaid BUSINESS PLATE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines

ENERIE BERNOLO AQUINO

Affiant
Competent Proof of Identity:
_________________________________

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JESSIE LAMBID LAYESE, of legal age, single, Filipino, and a
resident of Samantha Homes, Bago Galleria, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of a CASH CARD with number 603131-0160-

3210-08 duly issued by the University of Mindanao;

That the aforesaid CASH CARD has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines

JESSIE LAMBID LAYESE

Affiant
Competent Proof of Identity:
SSS ID No.: 09-1482938-0

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ASLIA D. CALI, of legal age, single, Filipino, and a resident of

Boulevard Trading, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:
That I am a holder of a SCHOOL IDENTIFICATION CARD with
number 448849 duly issued by the University of Mindanao;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines

ASLIA D. CALI
Affiant

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, AROON IBASCO BUXANI, of legal age, married, Filipino, and a

resident of Talomo, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am a holder of a BUSINESS PLATE duly issued by the

Business Bureau of Davao City;

That the aforesaid BUSINESS PLATE has been inadvertently lost,

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines

AROON IBASCO BUXANI

Affiant
Competent Proof of Identity:
Comelec VIN: 2402-1399C-D1171AIB10000

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PRINCESS GRACE DIAZ BUNCALAN, of legal age, single,

Filipino, and a resident of Blk 1 Lot5, Mutual Homes, Buhangin, Davao
City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am a holder of a PHILIPPINE PASSPORT with number

EB5103717 duly issued by the Department of Foreign Affairs (DFA);

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost, dropped, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th

day of September 2014 at Davao City, Philippines
PRINCESS GRACE DIAZ BUNCALAN
Affiant
Competent Proof of Identity:
ID No.: ______________

SUBSCRIBED AND SWORN to before me this 5th day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, TRYZEAL TORREON RILLO, of legal age, single, Filipino, and a

resident of Km. 23 Bunawan, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a TAX IDENTIFICATION NUMBER (TIN) 301-

085-661-000 duly issued by the Bureau of Internal Revenue (BIR);

That the aforesaid TIN has been inadvertently lost, dropped, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4 th

day of September 2014 at Davao City, Philippines

TRYZEAL TORREON RILLO

Affiant
Competent Proof of Identity:
SSS ID NO.: 09-2635929-1
SUBSCRIBED AND SWORN to before me this 4th day of September
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RYAN JULIUS M. ISLA, of legal age, single, Filipino, and a

resident of San Francisco de Asis, Matina, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a CASH CARD AUTOMATED TELLER

MACHINE (ATM) CARD under account number 6031310160208643
duly issued by Landbank of the Philippines, C.M. Recto Branch, Davao
City;

That the aforesaid CASH CARD AUTOMATED TELLER MACHINE

(ATM) CARD has been inadvertently lost, dropped, or missing from my
possession, and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of September 2014 at Davao City, Philippines.

RYAN JULIUS M. ISLA

Affiant
Competent Proof of Identity:
PhilHealth ID No.: 19-0899479768-5

SUBSCRIBED AND SWORN to before me this 3rd day of September

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, WENELITO F. CLAPANO, of legal age, married, Filipino, and a

resident of Rivera Village, Bajada, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a PRC IDENTIFICATION CARD and PRC

IDENTIFICATION CARD DUPLICATE duly issued by the Professional
Regulations Commission (PRC);

That the aforesaid PRC IDENTIFICATION CARD and PRC

IDENTIFICATION CARD DUPLICATE have been inadvertently lost,
dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering them, the same could no longer be found hence, I
consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of September 2014 at Davao City, Philippines

WENELITO F. CLAPANO
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LARRY TESORO LUMBAB., of legal age, married, Filipino, and a

resident of Mineral Village, Garcia Heights, Bajada, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of an IDENTIFICATION CARD duly issued by

Pag-IBIG Fund, Davao City;

That the aforesaid IDENTIFICATION CARD has been inadvertently

lost, dropped, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of September 2014 at Davao City, Philippines

LARRY TESORO LUMBAB

Affiant
Competent Proof of Identity:
SSS ID No.: 09-2759728-5

SUBSCRIBED AND SWORN to before me this 3rd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, DOLLY NUMERON SOLIVERES, of legal age, Filipino, and a

resident of Rosario, Agusan del Sur, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the authorized representative of a TRANSCRIPT OF

RECORDS (T.O.R.) duly issued by Agusan del Sur State College of
Agriculture in Information Technology, Bunawan, Agusan del Sur;

That the above-mentioned TRANSCRIPT OF RECORDS has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of September 2014 at Davao City, Philippines.

DOLLY NUMERON SOLIVERES

Authorized Representative
Competent Proof of Identity:
PhilHealth ID No.: 18-025193219-9

SUBSCRIBED AND SWORN to before me this 3rd day of September

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EVELYN E. VELASQUEZ, of legal age, Filipino, and a resident of

#2 Charity St., Pag-ibog Subd., Cabantian, Buhangin, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the authorized representative of a PAWN PAPER with

ticket number 2079 duly issued by Wenadin Pawnshop, Inc., Buhangin
Branch;

That the above-mentioned PAWN PAPER has been inadvertently

lost, dropped, or missing from my possession, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of September 2014 at Davao City, Philippines.

EVELYN E. VELASQUEZ
Authorized Representative
Competent Proof of Identity:
OSCA ID No.: 12-006923

SUBSCRIBED AND SWORN to before me this 3rd day of September

2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MELVIN PARDILLO FERNANDEZ, of legal age, single, Filipino,

and a resident of Buhangin, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of an OFFICIAL RECEIPT for a LOAN AND

MORTGAGE AGREEMENT duly issued by Pag-IBIG Fund;
That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,
dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of September 2014 at Davao City, Philippines

MELVIN PARDILLO FERNANDEZ

Affiant
Competent Proof of Identity:
TIN: 901-833-070

SUBSCRIBED AND SWORN to before me this 2nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROLLY P. DE ASIS JR., of legal age, single, Filipino, and a

resident of Ontorium St., NHA Bangkal, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an SCHOOL IDENTIFICATION CARD duly

issued by Davao Doctors College, Malvar St., Davao City;

That the aforesaid SCHOOL IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of September 2014 at Davao City, Philippines

ROLLY P. DE ASIS JR.

Affiant

SUBSCRIBED AND SWORN to before me this 2nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOAN IBASCO BALANSAG, of legal age, Filipino, and a resident

of Doña Asuncion, Pampanga, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of an INCOME TAX RETURN (ITR) under TIN

926-909-274 duly issued by Bureau of Internal Revenue, Davao City;

That the aforesaid INCOME TAX RETURN (ITR) has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of September 2014 at Davao City, Philippines.
JOAN IBASCO BALANSAG
Affiant
Competent Proof of Identity:
LTO License No.: L02-04-177467

SUBSCRIBED AND SWORN to before me this 2nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAY JEAN VILLAMOR MAHINAY, of legal age, single, Filipino,

and a resident of South San Juan Village, Agdao, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of an AUTOMATED TELLER MACHINE CARD

under account number 9-009-87927-2 duly issued by Rizal
Commercial Banking Corporation (RCBC), Sta. Ana Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE CARD has

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of September 2014 at Davao City, Philippines.

RAY JEAN VILLAMOR MAHINAY

Affiant
Competent Proof of Identity:
Philippine Passport: EB5609811
SUBSCRIBED AND SWORN to before me this 2nd day of September
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RICOGEEN POJEDA EDICA, of legal age, married, Filipino, and a

resident of Blk B22 Lot 8, Phase 1, S.I.R. New Matina, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of a LICENSE CARD duly issued by the Land

Transportation Office (LTO) of Davao City;

That the aforesaid LICENSE CARD has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of September 2014 at Davao City, Philippines

RICOGEEN POJEDA EDICA

Affiant
Competent Proof of Identity:
PhilHealth ID No.: 17-025324628-9

SUBSCRIBED AND SWORN to before me this 2nd day of September

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JANE PUERTO ONG, of legal age, married, Filipino, and a resident

of Phase 9B, Blk 19 Lot 11, Deca Homes, Mintal, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of an OFFICIAL RECEIPT with number 1665

worth Php 4,000.00 duly issued by Emcor, Inc., R. Castillo Agdao Branch,
Davao City;

That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

2nd day of September 2014 at Davao City, Philippines

JANE PUERTO ONG

Affiant
Competent Proof of Identity:
Philippine Passport No.: EC1654867

SUBSCRIBED AND SWORN to before me this 2nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, AURORA JHONSON PARAISO, of legal age, married, Filipino, and

a resident of ^80 –A DDF Village, Mandug, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an Identification Card duly issued by

Philippine Health Insurance Inc.;

That the aforesaid ID has been inadvertently lost, dropped, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd

day of September 2014 at Davao City, Philippines

AURORA JHONSON PARAISO

Affiant
Competent Proof of Identity:
OSCA ID No.: 2481847

SUBSCRIBED AND SWORN to before me this 2nd day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, GULBUDDIN AMIL TUDON, of legal age, single, Filipino, and a
resident of Poblacion Datu Paglas, Maguindanao, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a PAWNPAPER with an iPhone as the

pawned item duly issued by Reymalyn Pawnshop, Bolton Branch, Davao
City;

That the aforesaid PAWNPAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

GULBUDDIN AMIL TUDON

Affiant
Competent Proof of Identity:
Postal ID No.: 1870654

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ERLINDO M. LUMONTAD SR., of legal age, Filipino, and a

resident of 103 Km. 11 Catalunan Pequeño, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:
That I am the holder of an OFFICIAL RECEIPT with series
number 3650-3700 duly issued by the Bureau of Internal Revenue (BIR)
for ERLJOYCE STEEL WORKS, located at km. II Purok 4, Catalunan
Pequeño, Davao City;

That the aforesaid OFFICIAL RECEIPT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

ERLINDO M. LUMONTAD SR.

Affiant
Competent Proof of Identification:
TIN: 182-352-159

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LAURA CECILIA LORRAINE TADURAN CASTRO, of legal age,

married, Filipino, and a resident of 617 Aguho St., Juna Subd., Matina,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a POLICY CONTRACT under number

N10340134 duly issued by St. Peter Life Plan, Inc.;
That the aforesaid POLICY CONTRACT has been inadvertently lost,
dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

LAURA CECILIA LORRAINE TADURAN CASTRO

Affiant
Competent Proof of Identification:
SSS ID No.: 09-2480873-1

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, YOLLY S. DIOSANA, of legal age, married, Filipino, and a

resident of Alamada, North Cotabato, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT with bearing

number XX4267569 duly issued by the Department of Foreign Affairs
(DFA) of Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost, dropped, or missing from my possession sometime last July of 2009
as I was riding a PUJ in Davao City, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

YOLLY S. DIOSANA
Affiant
Competent Proof of Identification:
PhilHealth ID No.: 17-200952908-5

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, YOLLY S. DIOSANA, of legal age, married, Filipino, and a

resident of Alamada, North Cotabato, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT with bearing

number XX4267569 duly issued by the Department of Foreign Affairs
(DFA) of Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines
YOLLY S. DIOSANA
Affiant
Competent Proof of Identification:
PhilHealth ID No.: 17-200952908-5

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, STANLEY P. ALAMANSA, of legal age, Filipino, and a resident of

Buhisan, Purok 16, Tubungco, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (LTO) of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

STANLEY P. ALAMANSA
Affiant
SUBSCRIBED AND SWORN to before me this 1st day of September
2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHRISTOPHER E. PLAZA, of legal age, Filipino, and a resident of

Badella, Buhangin, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (LTO) of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

CHRISTOPHER E. PLAZA
Affiant

SUBSCRIBED AND SWORN to before me this 1st day of September

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MERIDEL L. YNION, of legal age, Filipino, and a resident of #12

Second Street, Mabini Blvd. Brgy. 31-D, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a PAWNPAPER with a necklace as the

pawned item duly issued by Rosver Pawnshop, San Pedro Branch, Davao
City;

That the aforesaid PAWNPAPER has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

MERIDEL L. YNION
Affiant

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, RHEA INTO PALER, of legal age, Filipino, and a resident of Doña

Asunscion, Phase 1, Purok 4, Pampanga, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a PHILIPPINE PASSPORT with number

XX0681105 duly issued by the Department of Foreign Affairs (DFA) of
Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

left at a PUJ I was boarding in the way to Metrobank Buhangin last August
22, 2014 at 9:30AM, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

RHEA INTO PALER

Affiant
Competent Proof of Identity:
UM-P ID: CRN-0111-2524993-6

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

I, CLARK R. VALDERRAMA, of legal age, Filipino, and a resident of

Purok 7, Panacan Relocation, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (Lto) of Davao City;

That the aforesaid DRIVER’S LICENSE has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

CLARK R. VALDERRAMA
Affiant
Competent Proof of Identity:
CTC No.: 13977826

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOSEPH RELOS EVANGELISTA, of legal age, Filipino, and a

resident of Phase 1, Blk 3 Lot 2, NHA Bangkal, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of an AUTOMATED TELLER MACHINE CARD

under account number 002-58-199652 duly issued by One Network
Bank, San Pedro Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE CARD has

been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

day of September 2014 at Davao City, Philippines

JOSEPH RELOS EVANGELISTA

Affiant
Competent Proof of Identity:
LTO License No.: D12-88-013306

SUBSCRIBED AND SWORN to before me this 1st day of September

2014 at Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

I, EDGAR M. CHUA, of legal age, Filipino, and a resident of Davao

City Philippines, after having been duly sworn to in accordance with law,
do hereby depose and say,

That I am the Territory Manager of Alsons Aquaculture Corporation;

That I am a holder of STATEMENTS OF ACCOUNT duly issued by

the Alsons Aquaculture Corporation describe as follows;

P.O. P.O. Number Invoi Invo Amount

Date ce Date ice
Number
July 8- 8/9/ 146 55,739.
15 2014 2014 80 01
July 16- 8/9/ 146 51,789.
22 2014 2014 81 38
July 22- 8/9/ 146 68,893.
31 2014 2014 82 56
July 15 009-0120195 7/16 145 2,000.0
2014 /2014 18 0
May 8 3430682-0 & 7/12 144 50,000.
2014 3430677-0 /2014 96 00
July 14 3540947-0 7/17 145 31,206.
2014 /2014 19 34
May 8 3430654-0 & 7/12 145 15,000.
2014 3430061-0 /2014 00 00
May 8 3430676-0 & 7/17 145 15,000.
2014 3430671-0 /2014 21 00
July 15 3541408-0 7/17 145 23,439.
2014 /2014 20 20
July 9 3533667-0 & 7/16 145 5,000.0
2014 3533670-0 /2014 12 0

That the above-mentioned STATEMENTS OF ACCOUNT were lost or dropped and

despite of diligent efforts to locate them, the same could no longer be found hence, I
consider them lost.

That I am executing this affidavit to attest the truth of the foregoing facts for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this August 29, 2014
at Davao City, Philippines.

EDGAR M. CHUA
Affiant
Competent proof of Identity:
Company ID No.: AA-1-11445-6

SUBSCRIBED AND SWORN to before me this August 29, 2014 at Davao City, Philippines.

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, VILLALON VENTURA BURGOS, of legal age, Filipino, married,
and a resident of NHA Bangkal, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of an Identification Cards described as follows;

Philippine National Police (PNP) Identification Card
PSSLAI Identification Card
AFSLAI Identification Card
PSMBFI Identification Card

That the aforesaid Identification Cards has been inadvertently lost,

dropped, or missing from my possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 27, 2014 at Davao City, Philippines

VILLALON VENTURA BURGOS

Affiant
Competent Proof of Identity:
________________________________

SUBSCRIBED AND SWORN to before me this August 27, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, EDUARDO E. OMEGA JR., of legal age, Filipino, married, and a

resident of Phase 8C Blk 44 Lot 1 Deca Homes Resort Residences,
Tacunan, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:
That I am the holder of a SMART Prepaid Sim Card with a
number +639028-2768-968

That the aforesaid SIM CARD has been inadvertently lost, dropped,
or missing from my possession last August 22, 2014, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 28, 2014 at Davao City, Philippines

EDUARDO E. OMEGA JR.

Affiant
Competent Proof of Identity:
SSS Id No.: 06-0397171-4

SUBSCRIBED AND SWORN to before me this August 28, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, APOLINARIO M. PADONG, of legal age, Filipino, married, and a

resident of Phase 1, Blk 5 Lot 13, Daffodil St., Roseville Subd., Angliongto,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a POLICY CONTRACT under policy

number 0321335026 duly issued by PHILAM LIFE;

That the aforesaid POLICY CONTRACT has been inadvertently lost

due to a flood at our residence about 2 years ago, and despite of diligent
efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 22, 2014 at Davao City, Philippines

APOLINARIO M. PADONG
Affiant
Competent Proof of Identity:
OSCA ID No.: 26073

SUBSCRIBED AND SWORN to before me this August 22, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, PO3 PETER ACOLENTAVA BAUTISTA of legal age, Filipino, and

a resident of Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a PSMBFI CASH CARD duly issued by the

Rizal Commercial Banking Corporation (RCBC) of Davao City;

That the aforesaid CASH CARD has been inadvertently lost,

dropped, or missing from my possession last April 2014 at 4:00 PM, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 20, 2014 at Davao City, Philippines
PO3 PETER ACOLENTAVA BAUTISTA
Affiant
Competent Proof of Identity:
PNP ID No.: 11L060195

SUBSCRIBED AND SWORN to before me this August 20, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, PO3 PETER ACOLENTAVA BAUTISTA of legal age, Filipino, and

a resident of Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a PSSLAI ATM CARD duly issued by the

Philippine National Bank of Davao City;

That the aforesaid ATM CARD has been inadvertently lost,

dropped, or missing from my possession last April 2014 at 4:00 PM, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 20, 2014 at Davao City, Philippines

PO3 PETER ACOLENTAVA BAUTISTA

Affiant
Competent Proof of Identity:
PNP ID No.: 11L060195
SUBSCRIBED AND SWORN to before me this August 20, 2014 at
Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, CHERWIN MONDAS FERRANDO, of legal age, married, Filipino,

and a resident of Caraga, Davao Oriental, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a LTO LICENSE CARD duly issued by the

Land Transportation Office (LTO) of Davao City;

That the aforesaid LTO LICENSE CARD has been inadvertently lost,
dropped, or missing from my possession last August 19, 2014 at 4:00 PM,
and despite of diligent efforts to locating and recovering it, the same
could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 20, 2014 at Davao City, Philippines

CHERWIN MONDAS FERRANDO

Affiant
Competent Proof of Identity:
SSS ID No.: 09-2935060-8

SUBSCRIBED AND SWORN to before me this August 20, 2014 at

Davao City, Philippines
Doc. No. _______; ALEXIS M. LUMBATAN
Page No. _______; Notary Public
Book No. _______; Until December 31, 2015
Series of 2014. Roll of Attorney’s No. 54826
PTR OR. No. 3809738-12/19/13- Davao City
IBP OR. No. 913105-12/19/13-Davao City
MCLE Compliance No. IV-0020750

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NEIL SARIGUMBA TAYABAS, of legal age, single, Filipino, and a

resident of San Miguel Villa Centro Agdao, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a TIN CARD with Identification Number

168-823-336-000 duly issued by the Bureau of Internal Revenue (BIR) of
Davao City;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 19, 2014 at Davao City, Philippines

NEIL SARIGUMBA TAYABAS

Affiant
Competent Proof of Identity:
SSS ID No.:09-1551090-2

SUBSCRIBED AND SWORN to before me this August 19, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, CONCEPCION CAIRO SALIG, of legal age, married, Filipino, and a

resident of Birhen sa Lourdes, Indangan, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM)

CARD with number 4404528827826466 and under account number
10025-000-100 duly issued by Union Bank, Victoria Plaza Branch, Davao
City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD

has been inadvertently lost, dropped, or missing from my possession, and
despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this August

12, 2014 at Davao City, Philippines

CONCEPCION CAIRO SALIG

Affiant
Competent Proof of Identity:
SSS ID No.: 09-2669621-3

SUBSCRIBED AND SWORN to before me this August 12, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS
I, GRACE V. DELMORO, of legal age, single, Filipino, and a resident
of Roxas St., Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a COMPANY IDENTIFICATION CARD duly

issued by PREMIERE CORPORATE STANDARDS, INC., Davao City;

That the aforesaid COMPANY IDENTIFICATION CARD has been

inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 12, 2014 at Davao City, Philippines

GRACE V. DELMORO
Affiant
Competent Proof of Identity:
ID No. __________________

SUBSCRIBED AND SWORN to before me this August 12, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

AFFIDAVIT OF LOSS

I, GRACE V. DELMORO, of legal age, single, Filipino, and a resident

of Roxas St., Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a RECEIPT for a cooler purchased at SM City

Davao, Ecoland, Davao City;

That the aforesaid RECEIPT has been inadvertently lost, dropped,

or missing from my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 12, 2014 at Davao City, Philippines

GRACE V. DELMORO
Affiant
Competent Proof of Identity:
ID No. __________________

SUBSCRIBED AND SWORN to before me this August 12, 2014 at

Davao City, Philippines

Doc. No. _______; ALEXIS M. LUMBATAN

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROXANN DE LEON LAO, of legal age, single, Filipino, and a

resident of Upper Tamugan, Marilog District, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently

lost, dropped, or missing from my possession at Iloilo City last January
2014, and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
August 12, 2014 at Davao City, Philippines

ROXANN DE LEON LAO

Affiant
Competent Proof of Identity:
LTO License No.: F03-13-004360

SUBSCRIBED AND SWORN to before me this August 12, 2014 at

Davao City, Philippines

Doc. No. _______;

Page No._______;
Book No. _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ALICIA BONHOC CARRIDO, of legal age, married, Filipino, and a

resident of Lot 19 Blk 10 Circumferential Road, Doña Vicenta Village,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a PASSBOOK under Savings Account No.

009-01-000685-9 duly issued by WealthBank, Magallanes Branch, Davao
City;

That the aforesaid PASSBOOK has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 12, 2014 at Davao City, Philippines
ALICIA BONHOC CARRIDO
Affiant
Competent Proof of Identity:
LTO License No.: L02-94-099143

SUBSCRIBED AND SWORN to before me this August 12, 2014 at

Davao City, Philippines

Doc. No. _______;

Page No._______;
Book No. _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROBERTO NELL JONE MAKINANO ASTUDILLO III, of legal age,

married, Filipino, and a resident of Blk 2 Lot 12 Deca Homes Cabantian,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the holder of a Driver’s License duly issued by Land

Transportation Office of Davao City;

That the aforesaid Driver’s License has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 8, 2014 at Davao City, Philippines

ROBERTO NELL JONE MAKINANO ASTUDILLO III

Affiant
Competent Proof of Identity:
UM-P ID NO. CRN 0009-2011132-5

SUBSCRIBED AND SWORN to before me this August 8, 2014 at

Davao City, Philippines
Doc. No. _______;
Page No._______;
Book No. _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHONA B. LAGUNZAD, of legal age, Filipino, and a resident of 27

Springdale St., Hillcrest Subd., Diversion Road, Matina Balusong, Davao
City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM) CARD

duly issued by Land Bank of the Philippines, C.M. Recto Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD has

been inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this August

8, 2014 at Davao City, Philippines

CHONA B. LAGUNZAD
Affiant

SUBSCRIBED AND SWORN to before me this August 8, 2014 at Davao City,

Philippines

Doc. No. _______;

Page No._______;
Book No. _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ESTELITA A. IMNACIN, of legal age, Filipino, and a resident of

Las Arenas, Mandug, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the holder of a PAWNPAPER for a silver Sony digital camera,

duly issued by Reymallin Pawnshop;

That the aforesaid PAWNPAPER has been inadvertently lost, dropped, or

missing from my possession and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this August

7, 2014 at Davao City, Philippines

ESTELITA A. IMNACIN
Affiant
Competent Proof of Identity:
____________________________

SUBSCRIBED AND SWORN to before me this August 7, 2014 at Davao City,

Philippines

Doc. No. _______;

Page No._______;
Book No. _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, IRISH DOMINIC BATACAN KINTANAR, of legal age, Filipino,

single, and a resident of Pelayo St., Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:
That I am the holder of an Certificate of Registration (COR) duly issued
by Bureau of Internal Revenue (BIR) of Davao City;

That the aforesaid COR has been inadvertently lost, dropped, or missing
from my possession and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this August

6, 2014 at Davao City, Philippines

IRISH DOMINIC BATACAN KINTANAR

Affiant
Competent Proof of Identity:
____________________________

SUBSCRIBED AND SWORN to before me this August 6, 2014 at Davao City,

Philippines

Doc. No. _______;

Page No._______;
Book No. _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EMMIE BENLOT FERMIN of legal age, Filipino, single and a

resident of New Matina Gravahan, Davao City Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a TIN CARD issued by Bureau of Internal

Revenue (BIR) Davao City;

That the aforesaid TIN CARD has been inadvertently loss, missing
or dropped on my possession, and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

August 5, 2014 at Davao City, Philippines

EMMIE BENLOT FERMIN

Affiant
Competent Proof of Identity:
CTC NO. __________________

SUBSCRIBED AND SWORN to before me this August 5, 2014 at

Davao City, Philippines

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2014

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOHN ONG LEE, of legal age, Filipino, married, and a resident of

Davao City Philippines, after having been duly sworn to in accordance with
law, do hereby depose and state:

That I am the holder of a SIM CARD with SIM No. +63917-7348-333

issued by Globe Telecom;

That the aforesaid SIM CARD has been inadvertently lost, dropped, or
missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this August
4, 2014 at Davao City, Philippines

JOHN ONG LEE

Affiant
Competent Proof of Identity:
LTO License NO. G06-14-006087

SUBSCRIBED AND SWORN to before me this August 4, 2014 at Davao City,

Philippines

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2014

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ABELITA ICOT ESCASINAS, of legal age, Filipino, single, and a

resident of Purol 72 Quimpo Boulevard St. SIR PH 1, New Matina Davao
City Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of a TIN CARD with TIN No. 919-913-836 issued
by Bureau of Internal Revenue (BIR) Davao City;

That the aforesaid TIN CARD has been inadvertently lost, dropped, or
missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this August

4, 2014 at Davao City, Philippines
ABELITA ICOT ESCASINAS
Affiant
Competent Proof of Identity:
SSS ID NO. 09-2148253-2

SUBSCRIBED AND SWORN to before me this August 4, 2014 at Davao City,

Philippines

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FRANKIE JOHN MOLINA, of legal age, Filipino, single, and a

resident of Davao City Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a CHEQUE with the amount of PHP 92,614.20

issued by MARIETA F. DERAYAL from the Wealth Bank;

That the aforesaid CHEQUE has been inadvertently lost, dropped, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 30,

2014 at Davao City, Philippines

FRANKIE JOHN MOLINA

Affiant

SUBSCRIBED AND SWORN to before me this July 30, 2014 at Davao City,
Philippines
Doc. No. _______;
Page No._______;
Book No._______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SP04 LORETO A. MARANGA JR., of legal age, Filipino, married,

and a resident of Davao City Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am the holder of a PASSBOOK duly issued by AFPSLAI;

That the aforesaid PASSBOOK has been inadvertently lost, dropped, or

missing from my possession, and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 30,

2014 at Davao City, Philippines

SP04 LORETO A. MARANGA JR.

Affiant

SUBSCRIBED AND SWORN to before me this July 30, 2014 at Davao City,
Philippines

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MRYNA BARIQUIT MESIAS, of legal age, Filipino, married, and a

resident of Clarin St. Bo. Obrero, Davao City Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the aunt of Jerelyn Winzel Z. Somorostro who is minor

and currently studying at Davao Merchant Marine Academy of Davao
(DMMA)

That my niece is a holder of an Identification Card duly issued by Davao

Merchant Marine Academy of Davao (DMMA)

That the aforesaid ID has been inadvertently lost, dropped, or missing

from my possession, and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 30,

2014 at Davao City, Philippines

MRYNA BARIQUIT MESIAS

Affiant

SUBSCRIBED AND SWORN to before me this July 30, 2014 at Davao City,
Philippines

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, GRACE GUNDAYA OSHIRO, of legal age, Filipino, married, and a
resident of 04 Champaca St Panorama Homes Buhangin, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of a Bank Book Saving Account duly issued by

Philippine National Bank Gingoog City;

That the aforesaid Bank Book Saving Account has been inadvertently
lost, dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 30,

2014 at Davao City, Philippines

GRACE GUNDAYA OSHIRO

Affiant
Competent Proof of Identity:
Passport Bearing No. XX5700340

SUBSCRIBED AND SWORN to before me this July 30, 2014 at Davao City,
Philippines

Doc. No. _______;

Page No._______;
Book No._______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EFREN REYES ABRATIQUE, of legal age, Filipino, married, and a

resident of Sitio San Pedro, Catalunan Grande, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of a CERTIFICATE OF REGISTRATION duly issued

by the Department of Trade and Industry (DTI), Davao City for my ARAMA
CONCRETE PRODUCTS AND CONSTRUCTION SUPPLIES business with Business
Permit No. B-111079-9 and Business ID 2011-87636-2;
That the aforesaid CERTIFICATE OF REGISTRATION has been
inadvertently lost, dropped, or missing from my possession, and despite of
diligent efforts to locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 28,

2014 at Davao City, Philippines

EFREN REYES ABRATIQUE

Affiant
Competent Proof of Identity:
CTC No.: 01983968

SUBSCRIBED AND SWORN to before me this July 28, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JESUS P. SUBA-AN JR., of legal age, Filipino, married, and a

resident of 49-3 D. Ponce St., Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by

Department of Foreign Affairs (DFA), Davao City;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently lost,

dropped, or missing from my possession, and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 28,

2014 at Davao City, Philippines
JESUS P. SUBA-AN JR.
Affiant

SUBSCRIBED AND SWORN to before me this July 28, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PABLITO J. PABULARIO, of legal age, Filipino, married, and a

resident of Zone 4, North San Juan, Agdao, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an AUTOMATED TELLER MACHINE (ATM) CARD

duly issued by Metrobank, Magallanes Branch, Davao City;

That the aforesaid AUTOMATED TELLER MACHINE (ATM) CARD has

been inadvertently lost, dropped, or missing from my possession last July 27,
2014 as I was travelling from Camiguin to Davao, and despite of diligent efforts
to locating and recovering it, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 28,

2014 at Davao City, Philippines

PABLITO J. PABULARIO
Affiant
SUBSCRIBED AND SWORN to before me this July 28, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JUVELYN YRAY BOSTON, of legal age, Filipino, married, and a

resident of P-4 San Jose Dist., Island Garden City of Samal, Davao del
Norte, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by the

Department of Foreign Affairs (DFA) XI;

That the aforesaid PHILIPPINE PASSPORT has been inadvertently lost,

dropped, or missing from my possession last 10:00AM of March 21, 2014 and
despite of diligent efforts to locating and recovering it, the same could no longer
be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 25,

2014 at Davao City, Philippines

JUVELYN YRAY BOSTON

Affiant
Competent Proof of Identity:
CTC No.: 02504187

SUBSCRIBED AND SWORN to before me this July 25, 2014 at Davao City,
Philippines
Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAMEL DELANTAR , of legal age, Filipino, single, and a resident

of Agdao, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am a holder of a PAWN TICKET for 1 YG Bangle bet. 15.0 HK

duly issued by the M Lhuiller, Bajada Branch, Davao City with number
0602-2014-00901 pawned on June 21, 2014;

That the above-mentioned PAWN TICKET was misplaced or

dropped on my possession and despite of diligent efforts to locate it, the
same could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 24,

2014 at Davao City, Philippines.

RAMEL DELANTAR
Affiant

SUBSCRIBED AND SWORN to before me this July 24, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ROSEMARY P. DUMAPIAS , of legal age, Filipino, single, and a

resident of 477 Alley Malvar St., Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a PASSBOOK duly issued by the Wealth Bank

of Davao City;

That the above-mentioned PASSBOOK was misplaced or dropped

on my possession and despite of diligent efforts to locate it, the same
could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 23,

2014 at Davao City, Philippines.

ROSEMARY P. DUMAPIAS
Affiant
Competent Proof of Identity:
Driver’s License No. L02-06-006679

SUBSCRIBED AND SWORN to before me this July 23, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAY LERIO TADIOS, of legal age, Filipino, married, and a

resident of Purok 3, Gravahan, New Matina, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of an LTO LICENSE CARD duly issued by the

Land Transportation Office (LTO) of Davao;

That the above-mentioned LTO LICENSE CARD was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 21,

2014 at Davao City, Philippines.

RAY LERIO TADIOS

Affiant
Competent Proof of Identity:
Postal ID Card No.: 0397595

SUBSCRIBED AND SWORN to before me this July 21, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KAREN DELPUSO BONSOCAN, of legal age, Filipino, single, and

a resident of Purok Matibay, Tawantawan, Baguio Dist., Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM) CARD

under Account Number 001-12-022250-0 duly issued by the Asia United
Bank (AUB);
That the above-mentioned AUTOMATED TELLER MACHINE (ATM)
CARD was misplaced and despite of diligent efforts to locate it, the same
could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 21, 2014

at Davao City, Philippines.

KAREN DELPUSO BONSOCAN

Affiant
Competent Proof of Identity:
TIN: 405-011-351-000

SUBSCRIBED AND SWORN to before me this July 21, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHERIL OCTAVIO DE LA CRUZ, of legal age, Filipino, single, and

a resident of 2nd Floor Te Bldg., Corner Sobrecarey-Sta. Ana Avenue,
Davao City, Philippines, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD WITH CARD NUMBER 12201007592 under Account No.
2221399912 duly issued by the Chinabank, SM Megamall, Mandaluyong
Branch;

That the above-mentioned AUTOMATED TELLER MACHINE (ATM)

CARD was misplaced and despite of diligent efforts to locate it, the same
could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature July 21,
2014 at Davao City, Philippines.

CHERIL OCTAVIO DE LA CRUZ

Affiant
Competent Proof of Identity:
Postal ID No.: 2256189

SUBSCRIBED AND SWORN to before me this July 21, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROBIA RUBIO PIUS, of legal age, Filipino, married, and a resident

of #19 Pisces St., Pag-ibig Homes, Catalunan Grande, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am a holder of a HEALTH CARD duly issued by the City

Health Office of Davao City;

That the above-mentioned HEALTH CARD was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 21, 2014

at Davao City, Philippines.

ROBIA RUBIO PIUS

Affiant
Competent Proof of Identification:
PRC ID No.: 0765767
SUBSCRIBED AND SWORN to before me this July 21, 2014 at Davao
City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DULCE DELA CRUZ ALCORIZA, of legal age, Filipino, and a

resident of Buhangin, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD under ACCOUNT NUMBER 5464 9853 7465 4002 duly issued
by the MetroBank, Rizal Branch, Davao City;

That the above-mentioned AUTOMATED TELLER MACHINE (ATM)

CARD was misplaced and despite of diligent efforts to locate it, the same
could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 21, 2014

at Davao City, Philippines.

DULCE DELA CRUZ ALCORIZA

Affiant

SUBSCRIBED AND SWORN to before me this July 21, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PACITA DELA CRUZ ALCORIZA, of legal age, Filipino, and a

resident of Buhangin, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of an PHILHEALTH IDENTIFICATION CARD

duly issued by the PhilHealth, Davao City;

That the above-mentioned PHILHEALTH IDENTIFICATION CARD

was misplaced and despite of diligent efforts to locate it, the same could
no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 17, 2014

at Davao City, Philippines.

PACITA DELA CRUZ ALCORIZA

Affiant

SUBSCRIBED AND SWORN to before me this July 17, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, MATRONILLO S. TAMPUS, of legal age, Filipino, and a resident
of Midsayap, North Cotabato, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLER MACHINE (ATM)

CARD duly issued by the UnionBank, Magsaysay Branch, Davao City;

That the above-mentioned AUTOMATED TELLER MACHINE (ATM)

CARD was misplaced and despite of diligent efforts to locate it, the same
could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 17, 2014

at Davao City, Philippines.

MATRONILLO S. TAMPUS
Affiant

SUBSCRIBED AND SWORN to before me this July 17, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EULALIO NIGO BILOY, of legal age, Filipino, and a resident of Bo.

Obrero, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am a holder of a CERTIFICATE OF REGISTRATION for a

Motorcycle Unit with Plate No. 5519LC duly issued by the Bureau of
Internal Revenue, Davao City;
That the above-mentioned CERTIFICATE OF REGISTRATION was
misplaced and despite of diligent efforts to locate it, the same could no
longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 16, 2014

at Davao City, Philippines.

EULALIO NIGO BILOY

Affiant

SUBSCRIBED AND SWORN to before me this July 16, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LILIBETH T. PARRO, of legal age, Filipino, and a resident of Blk 2

Lot 11, Trinidad Greenhills, Ma-a, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a BUILDING PERMIT, CERTIFICATE OF

COMPLETION, and CERTIFICATE OF OCCUPANCY duly issued by the
City Engineer’s Office, Davao City;

That the above-mentioned BUILDING PERMIT, CERTIFICATE OF

COMPLETION, and CERTIFICATE OF OCCUPANCY were misplaced and
despite of diligent efforts to locate them, the same could no longer be
found hence, I consider them lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 15, 2014

at Davao City, Philippines.
LILIBETH T. PARRO
Affiant
Competent Proof of Identity:
LTO License No.: L02-97-122717

SUBSCRIBED AND SWORN to before me this July 15, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOYMIE DAYA PEPITO, of legal age, single, Filipino, and a

resident of Km 8, Tigatto, Buhangin, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of an AUTOMATED TELLEM MACHINE (ATM)

CARD duly issued by the Philippine National Bank (PNB);

That the above-mentioned AUTOMATED TELLEM MACHINE

(ATM) CARD was misplaced and despite of diligent efforts to locate it,
the same could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 14, 2014

at Davao City, Philippines.

JOYMIE DAYA PEPITO

Affiant
Competent Proof Identity:
Philippine Passport No.: EB7807755
SUBSCRIBED AND SWORN to before me this July 14, 2014 at Davao
City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARMEN J. MALLONGA, of legal age, Filipino, and a resident of

Lanzones St., Manggahan, Toril, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a E-CARD duly issued by the Government

Service Insurance System (GSIS);

That the above-mentioned E-CARD was misplaced last July 13, 2014
and despite of diligent efforts to locate it, the same could no longer be
found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 14, 2014

at Davao City, Philippines.

CARMEN J. MALLONGA
Affiant

SUBSCRIBED AND SWORN to before me this July 14, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RANIL OJA HASPE, of legal age, Filipino, married, and a resident

of Bankas Heights, Toril, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of a CLAIM STUB for CERTIFICATION duly

issued by the Professional Regulations Commission (PRC);

That the above-mentioned CLAIM STUB was misplaced and despite

of diligent efforts to locate it, the same could no longer be found hence, I
consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 14, 2014

at Davao City, Philippines.

RANIL OJA HASPE

Affiant
Competent Proof of Identity:
LTO License No.: L02-02-174279

SUBSCRIBED AND SWORN to before me this July 14, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, CHRIS JAN REY P. GALAPATE, of legal age, Filipino, single, and

a resident of Mitsui St., Bajada, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a MAXICARE CARD duly issued by the

company, OFFSOURCING PHILS.;

That the above-mentioned MAXICARE CARD was misplaced

sometime last December 2013 and despite of diligent efforts to locate it,
the same could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 11, 2014

at Davao City, Philippines.

CHRIS JAN REY P. GALAPATE

Affiant

SUBSCRIBED AND SWORN to before me this July 11, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARL EVAN M. LIMBRE, of legal age, Filipino, single, and a

resident of Toril, Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:
That I am a holder of a HEALTH CARD duly issued by the City
Health Office of Davao City;

That the above-mentioned HEALTH CARD was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature July 10, 2014

at Davao City, Philippines.

CARL EVAN M. LIMBRE

Affiant
Competent Proof of Identification:
CTC No.: 13902274

SUBSCRIBED AND SWORN to before me this July 10, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FERJOHN A. JANEO, of legal age, Filipino, single, and a resident

of Aurora St., Boulevard, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of a HEALTH CARD duly issued by the City

Health Office of Davao City;

That the above-mentioned HEALTH CARD was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature July 10, 2014
at Davao City, Philippines.

FERJOHN A. JANEO
Affiant
Competent Proof of Identification:
CTC No.: 13902874

SUBSCRIBED AND SWORN to before me this July 10, 2014 at Davao

City, Philippines

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, RAUL CORTEZ ESPIRITU, of legal age, Filipino, married, and a

resident of Bucana, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the holder of a DRIVER’S LICENSE duly issued by the

Land Transportation Office (LTO);

That the aforesaid DRIVER’S LICENSE has been inadvertently lost

or misplaced and despite of diligent efforts to locating and recovering it,
the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 10, 2014 at Davao City, Philippines
RAUL CORTEZ ESPIRITU
Affiant

SUBSCRIBED AND SWORN to before me this July 10, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, TEED S. ASILO, of legal age, Filipino, married, and a resident of

Subasta, Calinan District, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of an SSS IDENTIFICATION CARD with

number 09-2547828-3 duly issued by the Social Security System (SSS);

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 8, 2014 at Davao City, Philippines

TEED S. ASILO
Affiant
Competent Proof of Identity:
COMELEC ID VIN: 2402-3603B-C0184TSA10000

SUBSCRIBED AND SWORN to before me this July 8, 2014 at Davao

City, Philippines
Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EDDIE H. LORIA, of legal age, Filipino, single, and a resident of

Blk 30 Lot18, Rosalina Village, Bago Gallera, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the bearer of DELIVERY RECEIPT with NUMBER 85334,

INVOICE NUMBER 104768, and P.O. NO. 4510041829 delivered to Sumifru
Philppines Inc.;

That the above-mentioned DELIVERY RECEIPT was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 8, 2014 at Davao City, Philippines.

EDDIE H. LORIA
Affiant
Competent Proof of Identity:
LTO License No.: L02-13-015372

SUBSCRIBED AND SWORN to before me this July 8, 2014 at Davao

City, Philippines.

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, CARDIMAR P. LUAYON, of legal age, Filipino, single, and a
resident of NHA Phase 1, Blk. 1, East St., Anthony Village, Brgy. San
Antonio, Agdao, Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am the bearer of SUMIFRU PHILIPPINES INC. CASH

INVOICE with number 134998 duly issued by the Davao Diamond
Industrial Hardware and charged to Sumifru Philppines Inc.;

That the above-mentioned CASH INVOICE was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 8, 2014 at Davao City, Philippines.

CARDIMAR P. LUAYON
Affiant
Competent Proof of Identity:
Sumifru ID No.: 842209

SUBSCRIBED AND SWORN to before me this July 8, 2014 at Davao

City, Philippines.

Doc No ________;
Page No _______;
Book No _______;
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARLOS P. TABLON, of legal age, Filipino, married, and a

resident of Catalunan Grande, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:
That I am the holder of a TIME DEPOSIT CERTIFICATE under
ACCOUNT NO. 00001473001787 duly issued by the Landbank of the
Philippines, San Pedro Branch;

That the aforesaid TIME DEPOSIT CERTIFICATE has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 8, 2014 at Davao City, Philippines

CARLOS P. TABLON
Affiant
Competent Proof of Identity:
LTO License No.: L02-77-033861

SUBSCRIBED AND SWORN to before me this July 8, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHARNEL B. MAHUSAY, of legal age, Filipino, single, and a

resident of Purok 9, Km.12, Kawa-kawa, Catalunan Pequeño, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of an SSS IDENTIFICATION CARD with

number 332362939-8 duly issued by the Social Security System (SSS);

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 7, 2014 at Davao City, Philippines

CHARNEL B. MAHUSAY
Affiant
Competent Proof of Identity:
COMELEC ID VIN: 0308-0025B-K1776CBM20000

SUBSCRIBED AND SWORN to before me this July 7, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CHARNEL A. BETITO, of legal age, Filipino, single, and a resident

of Purok 9, Km.12, Kawa-kawa, Catalunan Pequeño, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of a PHILIPPINE PASSPORT with No. CC932184

duly issued by the Department of Foreign Affairs (DFA);

That the aforesaid PHILIPPINE PASSPORT has been inadvertently lost,

dropped, or missing from my possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this July 7,

2014 at Davao City, Philippines
CHARNEL A. BETITO
Affiant
Competent Proof of Identity:
COMELEC ID VIN: 0308-0025B-K1776CBM20000

SUBSCRIBED AND SWORN to before me this July 7, 2014 at Davao City,

Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PSYCHE T. ELDIALDE, of legal age, Filipino, single and a resident

of Blk 5 Lot 14, Rosalina Village, Puan, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of an SSS IDENTIFICATION CARD duly issued

by the Social Security System (SSS);

That the aforesaid SSS IDENTIFICATION CARD has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 7, 2014 at Davao City, Philippines

PSYCHE T. ELDIALDE
Affiant
Competent Proof of Identity:
PhilHealth ID No.: 16-050261841-2

SUBSCRIBED AND SWORN to before me this July 7, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FRANKLIN VIOS CAMILO, of legal age, Filipino, married and a

resident of Blk 25 Lot 34,36, DecaHomes, Cabantian, Buhangin, Davao
City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of a PAWN PAPER under Pawnticket No.

6038356017399 for the item of a WEDDING RING issued by Cebuana
Lhullier, Gaisano Mall Branch with loan date at June 20 2014, maturity
date at July 21 2014, and expiry date at October 20 2014;

That the aforesaid PAWN PAPER has been inadvertently lost or

misplaced and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 7, 2014 at Davao City, Philippines

FRANKLIN VIOS CAMILO

Affiant
Competent Proof of Identity:
TIN: 269-712-215-000

SUBSCRIBED AND SWORN to before me this July 7, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JENNIFER S. UGAL, of legal age, Filipino, married, and a resident

of Darong, Sta. Cruz, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the holder of a RECEIPT duly issued by the Boardwalk

Ventures;

That the aforesaid RECEIPT has been inadvertently lost or

misplaced and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 4, 2014 at Davao City, Philippines

JENNIFER S. UGAL
Affiant
Competent Proof of Identity:
Postal ID Card No.: 4889435

SUBSCRIBED AND SWORN to before me this July 4, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, LOURDES Y. PALICTE, of legal age, Filipino, widow, and a

resident of Lot 9 Blk 1, RGA Village, Cabaguio, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of an IDENTIFICATION CARD duly issued by

the Office for Senior Citizen Affairs (OSCA);

That the aforesaid IDENTIFICATION CARD has been inadvertently

lost or misplaced and despite of diligent efforts to locating and recovering
it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 4, 2014 at Davao City, Philippines

LOURDES Y. PALICTE
Affiant
Competent Proof of Identity:
PhilHealth ID No.: 16-0250407023-0

SUBSCRIBED AND SWORN to before me this July 4, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, CARLOS DISOR CUIZON, of legal age, Filipino, married and a

resident of Sito Soriano, Catalunan Grande, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:
That I am the holder of a CASH CARD duly issued by Pag-ibig Fund;

That the aforesaid CASH CARD has been inadvertently lost or

misplaced and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 4, 2014 at Davao City, Philippines

CARLOS DISOR CUIZON

Affiant
Competent Proof of Identity:
LTO License No.: L02-11-009664

SUBSCRIBED AND SWORN to before me this July 4, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, FRANKLIN VIOS CAMILO, of legal age, Filipino, married and a

resident of Blk 25 Lot 34,36, DecaHomes, Cabantian, Buhangin, Davao
City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am the holder of a PAWN PAPER for the item of a WEDDING

RING issued by Cebuana Lhullier, Gaisano Mall Branch;

That the aforesaid PAWN PAPER has been inadvertently lost or

misplaced and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;
That I am executing this affidavit to attest the truth of the foregoing
facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 4, 2014 at Davao City, Philippines

FRANKLIN VIOS CAMILO

Affiant
Competent Proof of Identity:
TIN: 269-712-215-000

SUBSCRIBED AND SWORN to before me this July 4, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOCELYN AURE BLANCO, of legal age, Filipino, married and a

resident of Brgy. Lapu-lapu, Agdao, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a CASH CARD duly issued by Land Bank of

the Philippines, San Pedro Branch;

That the aforesaid CASH CARD has been inadvertently lost or

misplaced and despite of diligent efforts to locating and recovering it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 3, 2014 at Davao City, Philippines

JOCELYN AURE BLANCO

Affiant

SUBSCRIBED AND SWORN to before me this July 3, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EDISON T. LIM, of legal age, Filipino, single and a resident of

Brgy. 28-C, Uyanguren,, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a HONORABLE DISMISSAL duly issued by

Mindanao State University, General Santos City;

That the aforesaid HONORABLE DISMISSAL has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 1, 2014 at Davao City, Philippines

EDISON T. LIM
Affiant
Competent Proof of Identity:
PHILHEALT ID No. 16-050487762-8

SUBSCRIBED AND SWORN to before me this July 1, 2014 at Davao

City, Philippines
Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ADAN C. CELESTE, of legal age, Filipino, married and a resident

of Purok 2, New Lezada Village, Toril, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a TENANT IDENTIFICATION CARD duly

issued by Victoria Plaza Mall;

That the aforesaid TENANT IDENTIFICATION CARD has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 1, 2014 at Davao City, Philippines

ADAN C. CELESTE
Affiant
Competent Proof of Identity:
CRN-0009-2526569-0

SUBSCRIBED AND SWORN to before me this July 1, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, PRESENTACION P. OMOSO, of legal age, Filipino, married and a

resident of Purok 2, New Lezada Village, Toril, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of CELLPHONE with Smart Sim Card No. +63939-
3833-833 and I am applying for a new Sim Card No.;

That the aforesaid CELLPHONE with Smart Sim Card has been
inadvertently lost or misplaced and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this June 27,

2014 at Davao City, Philippines

PRESENTACION P. OMOSO
Affiant

SUBSCRIBED AND SWORN to before me this June 27, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARK M. ALIPIO, of legal age, Filipino and a resident of Matina

Crossing, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am the holder of a PAWNPAPER with the item of (1) unit of

Samsung GT-S5303 with SD Memory Card duly issued by the Monte De or Pawn
paper, Acacia Branch, Davao City;

That the aforesaid PAWNPAPER has been inadvertently lost or misplaced

and despite of diligent efforts to locating and recovering it, the same could no
longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this June 27,

2014 at Davao City, Philippines

MARK M. ALIPIO
Affiant

SUBSCRIBED AND SWORN to before me this June 27, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARILE A. TARE, of legal age, Filipino and a resident of Camarin

Toril, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:
That I am the plan holder of BUSINESS PLATE duly issued by the
Business Bureau of Davao City;

That the aforesaid BUSINESS PLATE has been inadvertently lost, or

missing from my former store and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this June 26,

2014 at Davao City, Philippines

MARILE A. TARE
Affiant
Competent Proof of Identity:
TIN No. 918-142-138-000

SUBSCRIBED AND SWORN to before me this June 26, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARILOU J. VAILOCES, of legal age, Filipino, single, and a

resident of Purok Sweet Love, Dumagoc, Pagadian City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a PHILIPPINE PASSPORT duly issued by the

Department of Foreign Affairs (DFA);

That the aforesaid PHILIPPINE PASSPORT has been inadvertently lost,

dropped, or missing from my possession and despite of diligent efforts to
locating and recovering it, the same could no longer be found hence, I consider it
lost;
That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this June 26,

2014 at Davao City, Philippines

MARILOU J. VAILOCES
Affiant
Competent Proof of Identity:
TIN: 941-811-452

SUBSCRIBED AND SWORN to before me this June 26, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NANCY MATBAGON, of legal age, Filipino, married, and a

resident of Purok 25, People’s Village, Ma-a, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the mother of ROBERT JAY MATBAGON, a graduate of Davao

City National High School (DCNHS) last SY 2014 and has not enrolled into College
since;

That ROBERT JAY MATBAGON is the holder of a CERTIFICATE OF

GOOD MORAL CHARACTER and FORM 138 duly issued by the Davao City
National High School (DCNHS);

That the said CERTIFICATE OF GOOD MORAL CHARACTER and FORM

138 have been inadvertently lost, dropped, or missing from my possession and
despite of diligent efforts to locating and recovering them, the same could no
longer be found hence, I consider them lost;
That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this June 25,

2014 at Davao City, Philippines

NANCY MATBAGON
Affiant

SUBSCRIBED AND SWORN to before me this June 25, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY GRACE NUDALO, of legal age, Filipino, married, and a

resident of Don Isidro, Blk 3 Lot 6, Madapo Hills, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the mother of GRACE ANNIE NUDALO, a graduate of Davao

City National High School (DCNHS) last SY 2013 and has not enrolled into College
since;

That GRACE ANNIE NUDALO is the holder of a CERTIFICATE OF GOOD

MORAL CHARACTER and FORM 138 duly issued by the Davao City National
High School (DCNHS);

That the said CERTIFICATE OF GOOD MORAL CHARACTER and FORM

That I am executing this affidavit to attest the truth of the foregoing facts
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this June 25,

2014 at Davao City, Philippines
MARY GRACE NUDALO
Affiant

SUBSCRIBED AND SWORN to before me this June 25, 2014 at Davao City,
Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MICHAEL SILVANO NIMEZ, of legal age, Filipino, married, and a

resident of Purok 15, Km. 21, Budbud, Bunawan, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of a certain PHILIPPINE PASSPORT with #

XX3751829 duly issued by the Department of Foreign Affairs (DFA);

That the said PHILIPPINE PASSPORT with # XX3751829 was left

in an unidentified taxicab and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

June 23, 2014 at Davao City, Philippines

MICHAEL SILVANO NIMEZ

Affiant
Competent Proof of Identity:
SSS ID No.: 09-2425981-4

SUBSCRIBED AND SWORN to before me this June 23, 2014 at Davao

City, Philippines
Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOCEL M. MORELOS, of legal age, Filipino, single, a resident of

Km. 5 Gladiola St., Buhangin, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain SCHOOL IDENTIFICATION CARD

duly issued by the Davao Doctor’s College;

That the said SCHOOL IDENTIFICATION CARD was inadvertently

lost, dropped, or taken away from my possession, and despite of diligent
efforts on locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of June 2014, at Davao City, Philippines.
rd

JOCEL M. MORELOS
Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of June 2014,

at Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2014.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOCEL M. MORELOS, of legal age, Filipino, single, a resident of

Km. 5 Gladiola St., Buhangin, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain PAWNPAPER for a LAPTOP duly

issued by the Sanlaan Pawnshop Bolton branch;

That the said PAWNPAPER for a LAPTOP was inadvertently lost,

dropped, or taken away from my possession, and despite of diligent
efforts on locating and recovering it, the same could no longer be found
hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23 day of June 2014, at Davao City, Philippines.
rd

JOCEL M. MORELOS
Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of June 2014,

at Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, ELSIE PEPITO HEMIO, of legal age, Filipino, married, a resident
of Purok 4, Communal, Buhangin, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain AUTOMATED TELLER MACHINE

(ATM) CARD under Account Number 002790083602 duly issued by
the Banco de Oro (BDO) Buhangin branch;

That the said AUTOMATED TELLER MACHINE (ATM) CARD

under Account Number 002790083602 was stolen last June 22, 2014
and despite of diligent efforts to locating and recovering it, the same
could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

23rd day of June 2014, at Davao City, Philippines.

ELSIE PEPITO HEMIO

Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of June 2014,

at Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2014.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KATHLEEN R. RIOS, of legal age, Filipino, single a resident of

Zonta Relocation, Tibungco, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain PHILIPPINE PASSPORT with #

GG818924 duly issued by the Department of Foreign Affairs (DFA);
That the said PHILIPPINE PASSPORT with # GG818924 was left
in an unidentified taxicab and despite of diligent efforts to locating and
recovering it, the same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

September 23, 2013 at Davao City, Philippines

KATHLEEN R. RIOS
Affiant

SUBSCRIBED AND SWORN to before me this September 23, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JULIET RABIA BELLO, of legal age, Filipino, married a resident of

Quezon Boulevard, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the holder of a certain PHILIPPINE PASSPORT with #

EB6805386 duly issued by the Department of Foreign Affairs (DFA);

That the said PHILIPPINE PASSPORT has been inadvertently lost,

missing or dropped in his possession and despite of diligent efforts to
locate and recover them, the same could no longer be found hence, I
consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
November 05, 2013 at Davao City, Philippines

JULIET RABIA BELLO

Affiant
Competent proof of Identitification:
Phil Health No.: 16-025533864-9

SUBSCRIBED AND SWORN to before me this November 05, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, GRACE F. GEPAYO, of legal age, Filipino, a resident of Emily

Homes, Cabantian, Davao City, Philippines, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am the common-law wife of RODOLFO C. PARAIRO, an inmate

at the Davao Penal Colony.

That he I am a holder of CERTIFICATION AS COMMON-LAW WIFE

duly issued by the Davao Penal Colony.

That the said CERTIFICATION AS COMMON-LAW WIFE has been

inadvertently lost, missing or dropped in his possession and despite of
diligent efforts to locate and recover them, the same could no longer be
found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 30, 2013 at Davao City, Philippines.
GRACE F. GEPAYO
Affiant

SUBSCRIBED AND SWORN to before me this October 30, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARIBEL M. BLANZA, of legal age, Filipino, married a resident of

Purok 21, Mambusao, Ngan, Compostela Valley Province, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a certain PHILIPPINE PASSPORT with #

0234697 duly issued by the Department of Foreign Affairs (DFA);

That the above-mentioned PHILIPPINE PASSPORT was left inside

our house which was flooded by the Typhoon Pablo and despite of diligent
efforts to locate it, the same could no longer be found hence, I consider it
lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

November 4, 2013, at Davao City, Philippines.

MARIBEL M. BLANZA
Affiant
Competent proof of Identitification:
DSWD ID No.: 118201008-2437-00083
SUBSCRIBED AND SWORN to before me this October 24, 2013 at
Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LEIZEL C. RAMOS, of legal age, Filipino, married and a resident

of Wiltelcom SM Annex Ecoland, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of SIM CARD with # 639156991448 duly

issued by Samsung Gcash, Wiltelcom Sm Annex Ecoland, Davao City
Philippines;

That the above-mentioned SIM CARD was misplaced and despite of

diligent efforts to locate it, the same could no longer be found hence, I
consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 24, 2013 at Davao City, Philippines.

LEIZEL C. RAMOS
Affiant

SUBSCRIBED AND SWORN to before me this October 24, 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, JUDY M. AWITAN, of legal age, Filipino, and a resident of

Waterlily Village, Brgy. Aquino, Agdao, Davao City, after having been duly
sworn to depose and say:

That I am the holder of a certain PAWNPAPER issued at the

Cebuana Lhuiller Pawnshop, Agdao, Davao City with:

Customer Name : RICHELLE JOY AWITAN

Pawn Ticket No.: 50401sg007012
Loan Date : June 17, 2013
Maturity Date : July 18, 2013
Expiry Date : October 16, 2013
Amount : P 4,300.00
Description : Ladies ring, White Gold, 18k
Weight : 2.5grams

That recently I noticed that the abovementioned PAWNPAPER was lost

and despite of diligent efforts in locating the same it could not be found hence;
That I considered it lost and beyond recovery;
That I am executing this affidavit to inform the proper authorities
concerned of the foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this 16 th day

of October
2013 at Davao City, Philippines.

JUDY M. AWITAN
Affiant
Competent Proof of identity:
CHO ID No.: 700410

SUBSCRIBED AND SWORN TO before me this 16th day of October 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, ELIZALDE D. CELERINA, of legal age, Filipino, widow and a

resident of Super Island Miranda, Babak, Igacos, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am a holder of CARITAS IDENTIFICATION CARD with ID No.

R108-5010484 duly issued by the Caritas Health Shield, INC. at Davao
City.

That the above-mentioned IDENTIFICATION CARD was misplaced

and despite of diligent efforts to locate it, the same could no longer be
found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 23, 2013 at Davao City, Philippines.

ELIZALDE D. CELERINA
Affiant
Competent proof of Identity: OSCA ID No.: 96969

SUBSCRIBED AND SWORN to before me this October 23, 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ARNEL DEXTER L. BOOC, of legal age, Filipino, and a resident of

KM. 23, Purok 17, Bunawan, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of OFFICIAL RECEIPT and CERTIFICATE OF

REGISTRATION of my motorcycle unit.

That the said OFFICIAL RECEIPT and CERTIFICATE OF

REGISTRATION has been lost when our previous place was brought down
by fire;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 16, 2013 at Davao City, Philippines.

ARNEL DEXTER L. BOOC

Affiant
Competent proof of Identity: LTO License No.: L02-10-014371

SUBSCRIBED AND SWORN to before me this October 16, 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JENNIFER M. MIEL, of legal age, Filipino, and a resident of Block

38, Lot 23, Deca Homes, Tigatto, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a HEALTH CARD duly issued by the City

Health Office of Davao City;

That the above-mentioned HEALTH CARD was misplaced and

despite of diligent efforts to locate it, the same could no longer be found
hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature October 17,

2013 at Davao City, Philippines.
JENNIFER M. MIEL
Affiant
Competent Proof of Identification:
Phil Health ID No.: 16-025543326-9

SUBSCRIBED AND SWORN to before me this October 17, 2013 at

Davao City, Philippines

Doc No ________
Page No _______
Book No _______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, JOEL I. ALBIOS, and I am the representative of Davao Central

Warehouse, located at Agdao, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain COUNTER RECIEPT with DR. #

22573-Php. 9,500.00, DR. # 22597-Php. 5842.50, DR. # 22598-
Php. 13,950.75, DR. # 22599-Php. 17,541.75 duly issued by Davao
Central Warehouse Agdao Branch;

That the said COUNTER RECIEPT has been inadvertently lost,

missing or dropped in my possession and despite of diligent efforts to
locate and recover it, the same could no longer be found hence, I consider
it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 10, 2013, at Davao City, Philippines.

JOEL I. ALBIOS
Affiant
Competent Proof of Identification:
Company ID No.: 015

SUBSCRIBED AND SWORN to before me this October 10, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

+Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARICEL A. MAGLASANG, of legal age, Filipino, a resident of

San Vicente, Matanao, Davao del Sur, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain PHILIPPINE PASSPORT duly

issued by the Department of Foreign Affairs (DFA);

That the said PHILIPPINE PASSPORT was left in an unidentified

taxicab, and despite diligent efforts in locating and recovering it, the same
could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 7, 2013, at Davao City, Philippines.

MARICEL A. MAGLASANG
Affiant

SUBSCRIBED AND SWORN to before me this October 7, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, BASMA U. MANGANSAKAN, of legal age, Filipino, a resident of
Blk 12, Lot 8, Deca Homes, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the mother of NAGUIBSTARI U. MANGANSAKAN, a

student at Davao Doctor’s College (DDC) last 1st Semester of 2013.

That he is a holder of his SCHOOL IDENTIFICATION CARD duly

issued by the Davao Doctor’s College (DDC) with Student ID No. 13-
00208.

That the said SCHOOL IDENTIFICATION CARD with Student ID No.

13-00208 has been inadvertently lost, missing or dropped in his
possession and despite of diligent efforts to locate and recover it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 30, 2013 at Davao City, Philippines.

BASMA U. MANGANSAKAN
Affiant
Competent Proof of Identification: GSIS ID No. CRN-006-0072-8258-2

SUBSCRIBED AND SWORN to before me this October 30, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EDEN AFRONDOZA ANUDEN, of legal age, Filipino, a resident

of Luti Tigatto, Buhangin, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of a SCHOOL DIPLOMA duly issued by the

Cateel Vocational High School;

That the said SCHOOL DIPLOMA has been inadvertently lost,

missing or dropped in my possession and despite of diligent efforts to
locate and recover it, the same could no longer be found hence, I consider
it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

_________________ at Davao City, Philippines.

EDEN AFRONDOZA ANUDEN

Affiant
SUBSCRIBED AND SWORN to before me this _________________ at
Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, SUSAN PUEBLES ANTIPUESTO, and I am the common-law wife

of late RENATO VILLARJARDO CHAVOSO of legal age, Filipino, a
resident of Silver St., Brgy. 9-A, San Rafael Village, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am the holder of a certain FUNERAL RECIEPT duly

issued by the Colliado Funeral Homes, Kidapawan City.
That the above-mentioned FUNERAL RECIEPT has been
misplaced and could no longer be found hence, I consider it
lost.

That I am executing this affidavit to attest the truth of the

foregoing facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my
signature October 3, 2013 at Davao City, Philippines.

SUSAN PUEBLES ANTIPUESTO

Affiant
Competent Proof of Identification: SSS ID No.: 09-2910315-6

SUBSCRIBED AND SWORN to before me this October 3, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO )ss
x--------------x

AFFIDAVIT OF LOSS

I, MART ANTHONY L. MILLIONA, of legal age, Filipino, single

and a resident of Tawantawan, Baguio Dist., Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
say,

That I am a holder of HEALTH CARD, duly issued by the City Health

Office.

That the above-mentioned HEALTH CARD has been misplaced and

could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 11, 2013, at Davao City, Philippines.
MART ANTHONY L. MILLIONA
Affiant
Competent proof of Identity:
PhilHealth ID No.: 16-050476204-9

SUBSCRIBED AND SWORN to before me this October 11, 2013, at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, NEDDA GENE ALMERO LAMPIOS, of legal age, Filipino, a

resident Purok 12, Tibungco, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a School Identification Card duly issued by

the MATS College of Technology located at R Castillo Street, Agdao Davao
City.
That the said ID has been inadvertently lost, missing or dropped in
my possession and despite of diligent efforts to locate and recover it, the
same could no longer be found hence, I consider it lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 27, 2013 at Davao City, Philippines.

NEDDA GENE ALMERO LAMPIOS

Affiant
Competent proof of Identity: TIN Id # 427-949-628

SUBSCRIBED AND SWORN to before me this September 27, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, KATHLEEN R. RIOS, of legal age, Filipino, a resident of Zonta

Reloacation, Tibungco, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain PHILIPPINE PASSPORT with

No.66818924 duly issued by the Department of Foreign Affairs (DFA);

That the said PHILIPPINE PASSPORT with No.66818924 was left

in an unidentified taxicab, and despite diligent efforts in locating and
recovering it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 23, 2013 at Davao City, Philippines.

KATHLEEN R. RIOS
Affiant

SUBSCRIBED AND SWORN to before me this September 23, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, MARK ANTHONY BABALCON, of legal age, Filipino, and a

resident of Iñigo St., Barrio Obrero, Davao City, after having been duly
sworn to depose and say:

That I am the holder of a certain PAWNPAPER issued at the D’Vault

Pawnshop, located at Victoria Plaza, Davao City, Philippines, for this item:

1 ALCATEL ONE TOUCH

That recently I noticed that the abovementioned PAWNPAPER was

lost and despite of diligent efforts in locating the same it could not be
found hence;

That I considered it lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities

concerned of the foregoing facts and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this

23rd day of September 2013, at Davao City, Philippines.

MARK ANTHONY BABALCON

Affiant

SUBSCRIBED AND SWORN TO before me this 23rd day of September

2013, at Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, LYNDON G. ROBIS, of legal age, Filipino, a resident Purok 2,

Pantaron Sto. Tomas Davao Del Norte, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of a DIPLOMA duly issued by Sto. Tomas

National High School, Sto. Tomas Davao Del Norte.

That the said DIPLOMA has been inadvertently lost, misplaced

and/or misfiled and despite diligent efforts in locating it, the same could
no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 23, 2013 at Davao City, Philippines.

LYNDON G. ROBIS
Affiant
Competent proof of Identity: Unified Multi-Purpose CRN-0111-0324214-6

SUBSCRIBED AND SWORN to before me this September 23, 2013 at

Davao City, Philippines
Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY JANE M. SALMORIN, of legal age, Filipino, single and a

resident of Oceanville Homes Association, Dumoy, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am a holder of an SSS E-1 FORM duly issued by the Social

Security Services, Davao City;

That the said SSS E-1 FORM has been inadvertently lost, misplaced
and/or misfiled and despite diligent efforts in locating it, the same could
no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 17, 2013 at Davao City, Philippines.

MARY JANE M. SALMORIN

Affiant
Competent proof of Identity: CTC No. 02015568
SUBSCRIBED AND SWORN to before me this September 17, 2013 at
Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROSEMARIE C. TAMBIS, of legal age, Filipino, single and a

resident of My Hotel San Pedro St., Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a School Identification Card duly issued by

the University of Immaculate Conception, Davao City;

That the said School Identification Card has been inadvertently

lost, misplaced and/or misfiled and despite diligent efforts in locating it,
the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 17, 2013 at Davao City, Philippines.

ROSEMARIE C. TAMBIS
Affiant
Competent proof of Identity: MSU School ID No. 200954256

SUBSCRIBED AND SWORN to before me this September 17, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, LOVELY B. LAGAT, of legal age, Filipino, and a resident of Blk 3

Lot 4, Victors Subdivision, Brgy Communal, Davao City, after having been
duly sworn to depose and say:

That I am the holder of a certain PAWNPAPER issued at the De

Leon Pawnshop, Cabantian, Davao City, Philippines, for this item:

1 Necklace with Pendant

That recently I noticed that the abovementioned PAWNPAPER was lost and
despite of diligent efforts in locating the same it could not be found hence;

That I considered it lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities concerned of

the foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this 16 th day of

September 2013 at Davao City, Philippines.

LOVELY B. LAGAT
Affiant

SUBSCRIBED AND SWORN TO before me this 16th day of September 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO . . . . . ..)S.S.
X----------------X
AFFIDAVIT OF LOSS

I, IMELDA M. BARREDO, of legal age, Filipino, and a resident of

Blk 3 Lot 4, Victors Subdivision, Brgy Communal, Davao City, after having
been duly sworn to depose and say:

That I am the holder of THREE (3) PAWNING RECEIPTS issued at

the De Leon Pawnshop, Cabantian, Davao City, for these following items:

1 Necklace with 2 Pendants

Ring
Bracelet
That recently I noticed that the abovementioned PAWNING RECEIPTS were lost
and despite of diligent efforts in locating the same, they could not be found hence;

That I considered those receipts lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities concerned of

the foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this 16 th day of

September 2013 at Davao City, Philippines.

IMELDA M. BARREDO
Affiant
Competent Proof of identity:
PASSPORT No.: XX2940616

SUBSCRIBED AND SWORN TO before me this 16th day of September 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, DINNA U. ABANDO, of legal age, Filipino, and a resident of Sasa,

Davao City, after having been duly sworn to depose and say:
That I am the holder of a PAWNPAPER issued at the D’Vault
Pawnshop Corp., Victoria Plaza, Bajada, Davao City;

That the said PAWNPAPER has been inadvertently lost, misplaced

and/or misfiled and despite diligent efforts in locating it, the same could
no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this

16th day of September 2013 at Davao City, Philippines.

DINNA U. ABANDO
Affiant
Competent Proof of identity:
SM Company ID No.: 92570117-3

SUBSCRIBED AND SWORN TO before me this 16th day of September

2013 at Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, AURELIA N. DIONALDO, of legal age, Filipino, widow and a

resident of Datu Bago st. Matina Aplaya, Davao City Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
say:

That I am the wife of late ROGELIO ZAMORA DIONALDO, who

died last August 31 2013, a holder of a ST. PETER POLICY PLAN duly
issued by the St. Peter Life Plan Inc., located at Bonifacio St. Claveria
Davao City;
That the said ST. PETER POLICY PLAN has been inadvertently
lost, misplaced and/or misfiled and despite diligent efforts in locating it,
the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 12, 2013 at Davao City, Philippines.

AURELIA N. DIONALDO
Affiant
Competent Proof of Identification: CTC No. 22601558

SUBSCRIBED AND SWORN to before me this September 12, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY JANE M. ROXAS, of legal age, Filipino, single and a

resident of Blk 6, Brgy. 22-C, Piapi Blvd., Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of a School Identification Card dully issued by

the John Paul II College of Davao;

That the said School Identification Card has been inadvertently

lost, misplaced and/or misfiled and despite diligent efforts in locating it,
the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature
September 11, 2013 at Davao City, Philippines.

MARY JANE M. ROXAS

Affiant
Competent proof of Identity: HCDC School ID No. 48478805

SUBSCRIBED AND SWORN to before me this September 11, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DEVINA P. LAGARAS, of legal age, Filipino, and a resident of Blk.

5 Lot 3, Dama de Noche St., Bacaca Road, Bajada, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am a holder of a ST. PETER PLANHOLDER’S

IDENTIFICATION CARD duly issued by the St. Peter Life Plan Inc.

That the said ST. PETER PLANHOLDER’S IDENTIFICATION CARD

has been inadvertently lost, misplaced and/or misfiled and despite diligent
efforts in locating it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 7, 2013 at Davao City, Philippines.

DEVINA P. LAGARAS
Affiant

SUBSCRIBED AND SWORN to before me this October 7, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, S, of legal age, Filipino, single and a resident of Blk 3, Lot 3,

Spring Valley, Buhangin, Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain ORIGINAL CERTIFICATE OF

TITLE with No. P-10722 duly issued in the Bureau of Lands, Manila;

That last 2012, the said ORIGINAL CERTIFICATE OF TITLE, was

left inside my house in Manila when the typhoon Ondoy caused floods and
damaged our premises and despite diligent efforts in locating and
recovering it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 9, 2013 at Davao City, Philippines.

YOLANDA L. ARTOCILLA
Affiant
Competent Proof of Identification: Senior Citizens ID No. 13-004222

SUBSCRIBED AND SWORN to before me this September 9, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JEANETTE R. JUATON, of legal age, Filipino, single and a resident
of 38-5 R. Castillo St., Agdao, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the holder of a certain PHILIPPINE PASSPORT duly

issued in the Department of Foreign Affairs (DFA), Manila City;

That last August 18, 2000, my purse, where I kept the said
PHILIPPINE PASSPORT, was left in an unidentified taxicab, and despite
diligent efforts in locating and recovering it, the same could no longer be
found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 5, 2013 at Davao City, Philippines.

JEANETTE R. JUATON
Affiant
Competent Proof of Identification: Postal ID No. 6951077

SUBSCRIBED AND SWORN to before me this September 5, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ROGELIO L. RIVERA JR., of legal age, Filipino, single and a

resident of Lot 27 Blk 31 Phase 8C Deca Homes Tacunan Mintal, Davao
City, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state:

That I am a holder of a UIC Identification Card dully issued by the

University of Immaculate Conception located at Bankerohan, Davao City
and Uniform request form of DOH
That the said PRC License Card and PRC claim stub has been
inadvertently lost, misplaced and/or misfiled and despite diligent efforts in
locating it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature August

28, 2013 at Davao City, Philippines.

ROGELIO L. RIVERA JR.

Affiant
Competent proof of Identity: Passport Bearing No. EB1938019

SUBSCRIBED AND SWORN to before me this August 28, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MARY ANN J. DIGNADICE, of legal age, Filipino, and a resident of

227-A Jacinto Mapa St., Davao City, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state:

That I am a holder of Automated Teller Machine Card with

Account number 314558900024 and Card Number 5102-6601-
1000-1150, duly issued by the Philippine National Bank (PNB),
Magsaysay Branch, Davao City;

That the said Automated Teller Machine Card has been lost,
when I left it at the ATM machine after withdrawing last October 19, 2013.

That I wasn’t able to recover the same and it could no longer be

found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 21, 2013 at Davao City, Philippines.

MARY ANN J. DIGNADICE

Affiant
Competent proof of Identity: OSCA ID NO. 70339

SUBSCRIBED AND SWORN to before me this October 21, 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X
AFFIDAVIT OF LOSS

I, MARYSULPHA Y. BATILO , of legal age, Filipino, married and a

resident of JV ferroils, Lizada Toril, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of CEBU PACIFIC AIR ROUND TRIP PLANE

TICKET from DAVAO to MANILA-DAVAO dully issued by the AMSTAR
TRAVEL & TOURS located at Door 8 Dacudao Bldg. Duterte St. Davao City;

That the said PLANE TICKET has been inadvertently lost,

misplaced and/or misfiled and despite diligent efforts in locating it, the
same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature August

23, 2013 at Davao City, Philippines.

MARYSULPHA Y. BATILO
Affiant
Competent proof of Identity: TIN # 163-345-104

SUBSCRIBED AND SWORN to before me this August 23, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS
I, JUAN T. SIMANGAN, of legal age, Filipino, and a resident of
Grace Park Subd., Matina Pangi,, Davao City, Philippines, after having
been duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of a SAVINGS ACCOUNT PASSBOOK of Banco

de Oro C.M. Recto Branch.

That the said SAVINGS ACCOUNT PASSBOOK has been

inadvertently lost, misplaced and/or misfiled and despite diligent efforts in
locating it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature August

22, 2013 at Davao City, Philippines.

JUAN T. SIMANGAN
Affiant
Competent proof of Identity: Passport No.: XX1012513

SUBSCRIBED AND SWORN to before me this August 22, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, EL JOHN C. ESCALANTE, of legal age, Filipino, and a resident of

Tionko Avenue, Davao City, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state:

That I am a holder of COMPANY ID AND ACCESS CARD of

Sutherland Global Services.
That the said COMPANY ID AND ACCESS CARD has been
inadvertently lost, misplaced and/or misfiled and despite diligent efforts in
locating them, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature August

22, 2013 at Davao City, Philippines.

EL JOHN C. ESCALANTE
Affiant
Competent proof of Identity: COMELEC VIN No.: 6303-0069F-L1789ECE10000

SUBSCRIBED AND SWORN to before me this August 22, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, DOLORES L. TOCANTE, of legal age, Filipino, and a resident of

38 Macadamia Drive, Ecoland Phase 7, Matina, Davao City, Philippines,
after having been duly sworn to in accordance with law, do hereby depose
and state:

That I am a holder of RECEIPTS of PAYMENT for my loan with

Banco Davao for the Lot Nos. T-141227 and T-141226 at Phase 7,
Ecoland Subd., Davao City:

That while I was working as an OFW in Saudi Arabia at the time of

the full payment, the person I assigned to settle the load forgot to ask for
necessary clearances for the Registry of Deeds(ROD). Now, the said bank
is closed, and the said RECEIPTS of PAYMENT can no longer be found,
hence, I consider them lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 23, 2013 at Davao City, Philippines.

DOLORES L. TOCANTE
Affiant
Competent proof of Identity: Senior Citizen’s ID No. 25414

SUBSCRIBED AND SWORN to before me this September 23, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO )ss
x--------------x

AFFIDAVIT OF LOSS

I, FERNAND A. CALUMBA, of legal age, Filipino, single and a

resident of Phase 1, Apalet St., Doña Asuncion, Pampanga, Davao City,
Philippines, after having been duly sworn to in accordance with law, do
hereby depose and say,

That I am a holder of HEALTH CARD, duly issued by the City Health

Office.

That the above-mentioned HEALTH CARD has been misplaced and

could no longer be found hence, I consider it lost.

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 23, 2013, at Davao City, Philippines.

FERNAND A. CALUMBA
Affiant
Competent proof of Identity:
Victoria Plaza Department Store ID No.: 540-888-052513

SUBSCRIBED AND SWORN to before me this September 23, 2013, at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, MARIA SUYAT DORIA, of legal age, Filipino, and a resident of

Fatima Road Fatima Village Matina, Davao City, after having been duly
sworn to depose and say:

That I am the holder of a certain PAWNPAPER issued at the

Cebuana Lhuiller Pawnshop, Matina 1 , Davao City with:

Pawn Ticket No.: 50409sg025270 / 50409sg027047

Loan Date : June/17/2013 / August 10, 2013
Maturity Date : July/18/2013 / September 10, 2013
Expiry Date : October/16/2013 / December 09, 2013
Amount : P 7,000.00 / P 3,160.00
Description : Ladies ring with brill / Wedding ring
Weight : 3.3 grams / 2.9 grams

That recently I noticed that the abovementioned PAWNPAPER was lost and
despite of diligent efforts in locating the same it could not be found hence;

That I considered it lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities

concerned of the foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this 12 th day

of August 2013 at Davao City, Philippines.

MARIA SUYAT DORIA

Affiant
Competent Proof of identity:
Postal ID # 8900407

SUBSCRIBED AND SWORN TO before me this 12th day of August 2013 at

Davao City, Philippines.
Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, LALAINE L. ARGUELLES, of legal age, Filipino, and a resident of

345 Papaya St., Sto. Domingo II, Brgy. Pampanga, Sasa, Davao City, after
having been duly sworn to depose and say:

That I am the holder of a certain PAWNPAPER issued at the

Helen’s Pawnshop, Uyanguren Branch, Davao City;

That recently I noticed that the abovementioned PAWNPAPER was

lost and despite of diligent efforts in locating the same it could not be
found hence;

That I considered it lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities

concerned of the foregoing facts and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this

30th day of August 2013 at Davao City, Philippines.

LALAINE L. ARGUELLES
Affiant
Competent Proof of identity:
UM-P ID # CRN-0111-0047714-7

SUBSCRIBED AND SWORN TO before me this 30th day of August 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.

Republic of the Philippines)

CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS
I, ANNA LYNN ALDERETE, of legal age, Filipino, and a
resident of Km 18, Tibungco, Davao City, Philippines, after having been
duly sworn to depose and say:

That my late father was a policy holder of ST. PETER POLICY PLAN;

That recently I noticed that the abovementioned ST. PETER POLICY PLAN
was lost and despite of diligent efforts in locating the same it could not be
found hence;

That I considered it lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities

concerned of the foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this 9 th day

of September 2013 at Davao City, Philippines.

ANNA LYNN ALDERETE

Affiant

SUBSCRIBED AND SWORN TO before me this 9th day of September 2013 at

Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MCNARDY D. DIAMODA, of legal age, Filipino, and a resident of

St. Prk 3, Sapphire St., Doña Salud, Sasa, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am a holder of UNIFIED MULTI-PURPOSE IDENTIFICATION

CARD.

That the said UNIFIED MULTI-PURPOSE IDENTIFICATION CARD

has been inadvertently lost, misplaced and/or misfiled and despite diligent
efforts in locating it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

September 26, 2013 at Davao City, Philippines.

MCNARDY D. DIAMODA
Affiant
Competent proof of Identity: LTO License No.: L03-05-001964
SUBSCRIBED AND SWORN to before me this September 26, 2013 at
Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, VIRGINIA L. PAREÑAS, of legal age, Filipino, and a resident of

Km. 8, Sta. Cruz, Matina Pangi, Davao City, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and state:

That I am a holder of Tax Identification Number (TIN) Card duly

issued by Bureau of Internal Revenue.

That the said Tax Identification Number (TIN) Card has been
inadvertently lost, misplaced and/or misfiled and despite diligent efforts in
locating it, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 7, 2013 at Davao City, Philippines.
VIRGINIA L. PAREÑAS
Affiant
Competent proof of Identity: PhilHealth ID No.: 16-000017269-0

SUBSCRIBED AND SWORN to before me this October 7, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013

Republic of the Philippines)

CITY OF DAVAO . . . . . ..)S.S.
X----------------X

AFFIDAVIT OF LOSS

I, JOHN G. CELINO, employee of SUMITOMO (SHI) CYCLO DRIVE

ASIA PACIFIC, a company located at Makati City, Philippines, after having
been duly sworn to depose and say:

That I am the holder of a certain ORIGINAL OFFICIAL RECEIPT

duly issued by the Land Transportation Office, Davao City with the
following vehicle details:

1 ) MAKE & TYPE OF BODY : Chevrolet Optra Sedan 4-door

2 ) YEAR MODEL : 2005
3 ) CHASIS NO. : KL1NF196E5HIO6286
4 ) ENGINE NUMBER : F16D3-422523K
5 ) PLATE NUMBER : ZAZ 738
That recently I noticed that the abovementioned ORIGINAL
OFFICIAL RECEIPT was lost and despite of diligent efforts in locating the
same it could not be found;

That I considered it lost and beyond recovery;

That I am executing this affidavit to inform the proper authorities

concerned of the foregoing facts and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto affixed my signatures this

26th day of September 2013 at Davao City, Philippines.

JOHN G. CELINO
Affiant
Competent Proof of Identification: TIN No.: 161-813-939

SUBSCRIBED AND SWORN TO before me this 26th day of September

2013 at Davao City, Philippines.

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, STEPHANIE MAE P. CUBITA, of legal age, Filipino, and a resident

of Juan Luna St., Davao City, Philippines, after having been duly sworn to
in accordance with law, do hereby depose and state:

That I am a representative of Healthy Smile Dental Center situated

at SM City Davao.

That I am a holder of BUSINESS PERMIT and MAYOR’S PERMIT

duly issued by the Business Bureau.

That the said BUSINESS PERMIT and MAYOR’S PERMIT has been
inadvertently lost, misplaced and/or misfiled and despite diligent efforts in
locating them, the same could no longer be found;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

October 7, 2013 at Davao City, Philippines.

STEPHANIE MAE P. CUBITA

Affiant
Competent proof of Identity:
Healthy Smile Dental Center ID No.: 071809

SUBSCRIBED AND SWORN to before me this October 7, 2013 at

Davao City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2013.
Republic of the Philippines)
CITY OF DAVAO ) SS
X - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, MYLENE C. JAUM, of legal age, Filipino, single, and a resident of

Talomo, Meralex Compound, Cemento, Davao City, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and
state:

That I am the holder of a COMPANY IDENTIFICATION CARD duly

issued by the Marco Polo Davao;

That the aforesaid COMPANY IDENTIFICATION CARD has been

inadvertently lost or misplaced and despite of diligent efforts to locating
and recovering it, the same could no longer be found hence, I consider it
lost;

That I am executing this affidavit to attest the truth of the foregoing

facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 4, 2014 at Davao City, Philippines

MYLENE C. JAUM
Affiant

SUBSCRIBED AND SWORN to before me this July 4, 2014 at Davao

City, Philippines

Doc. No._______
Page No._______
Book No._______
Series of 2014.

The Wicked Step Mother 2
No ratings yet
The Wicked Step Mother 2
368 pages
Smart Weather Without Jira Project
No ratings yet
Smart Weather Without Jira Project
3 pages
PT Mora Telematika Indonesia ("Moratelindo") : Summary To Annual Report
No ratings yet
PT Mora Telematika Indonesia ("Moratelindo") : Summary To Annual Report
30 pages
Affidavit of Mutilation
No ratings yet
Affidavit of Mutilation
1 page
Affidavit of Loss (Passport)
No ratings yet
Affidavit of Loss (Passport)
2 pages
Affidavit of Mutilation of Passport Chua Yee Hin
No ratings yet
Affidavit of Mutilation of Passport Chua Yee Hin
1 page
Affidavit of Mutilation of Philippine Passport: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 4
No ratings yet
Affidavit of Mutilation of Philippine Passport: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 4
1 page
Affidavit of Explanation
0% (2)
Affidavit of Explanation
2 pages
Affidavit of Mutilation
No ratings yet
Affidavit of Mutilation
1 page
Affiavit of Mutilation, Passport - Termites
0% (1)
Affiavit of Mutilation, Passport - Termites
1 page
Affidavit of Loss Form - Passport
No ratings yet
Affidavit of Loss Form - Passport
1 page
Affidavit of Explanation
No ratings yet
Affidavit of Explanation
1 page
1.2.1 - Triumph Global Quality Manual and Appendix - Edition Jan 2010
100% (1)
1.2.1 - Triumph Global Quality Manual and Appendix - Edition Jan 2010
118 pages
Affidavit of Mutilation
100% (1)
Affidavit of Mutilation
2 pages
Affidavit of Mutilation: Republic of The Philippines) City of Dumaguete S.S)
No ratings yet
Affidavit of Mutilation: Republic of The Philippines) City of Dumaguete S.S)
2 pages
affidavit of loss (receipt)
No ratings yet
affidavit of loss (receipt)
3 pages
Affidavit of Mutilation
No ratings yet
Affidavit of Mutilation
1 page
Affidavit of Affidavit of Mutilation Baldedara JR
No ratings yet
Affidavit of Affidavit of Mutilation Baldedara JR
1 page
AFFIDAVIT OF MUTILATION (passport)
No ratings yet
AFFIDAVIT OF MUTILATION (passport)
2 pages
Affidavit of Loss: Reynaldo P. Alba Affiant
No ratings yet
Affidavit of Loss: Reynaldo P. Alba Affiant
2 pages
Affid of Passport Mutilation
No ratings yet
Affid of Passport Mutilation
1 page
Mutilation
No ratings yet
Mutilation
1 page
6 Affidavit of Mutilation
No ratings yet
6 Affidavit of Mutilation
1 page
Tamayo Torn
No ratings yet
Tamayo Torn
1 page
Affidavit of Explanation
No ratings yet
Affidavit of Explanation
3 pages
Aff. of Mutilated Diploma
No ratings yet
Aff. of Mutilated Diploma
3 pages
Baldoza Termites
No ratings yet
Baldoza Termites
1 page
Affidavit of Mutiltation
No ratings yet
Affidavit of Mutiltation
1 page
Affidavit of Destruction Passport
No ratings yet
Affidavit of Destruction Passport
1 page
Affidavit of Destruction Mutilation of Passport
No ratings yet
Affidavit of Destruction Mutilation of Passport
1 page
affidavit-for-damaged-or-mutilated-passport
No ratings yet
affidavit-for-damaged-or-mutilated-passport
1 page
Silvestre Wet
No ratings yet
Silvestre Wet
1 page
Affidavit Contracts Template
100% (1)
Affidavit Contracts Template
239 pages
Affidavit of Loss Nolirose
No ratings yet
Affidavit of Loss Nolirose
1 page
Affidavit of Loss of Passport
No ratings yet
Affidavit of Loss of Passport
2 pages
AFFIDAVIT OF MUTILATION OF PHILIPPINE PASSPORT
No ratings yet
AFFIDAVIT OF MUTILATION OF PHILIPPINE PASSPORT
1 page
Affidavit of Explanation No Passport - Sample
No ratings yet
Affidavit of Explanation No Passport - Sample
1 page
DFA Affidavit
No ratings yet
DFA Affidavit
1 page
Affidavit of Loss Boniao
No ratings yet
Affidavit of Loss Boniao
1 page
Affidavit of Mutilation
No ratings yet
Affidavit of Mutilation
1 page
affidavit of loss_driver's license
No ratings yet
affidavit of loss_driver's license
1 page
Affdavit of Loss Passport
No ratings yet
Affdavit of Loss Passport
5 pages
Affidavit of Destruction & Mutilation of Passport
No ratings yet
Affidavit of Destruction & Mutilation of Passport
1 page
Affidavit of Loss - Payslip
No ratings yet
Affidavit of Loss - Payslip
1 page
Affidavit of loss
No ratings yet
Affidavit of loss
1 page
AFFIDAVIT OF Mutilation of Passport
No ratings yet
AFFIDAVIT OF Mutilation of Passport
2 pages
Affidavit of Loss: Jay Christopher Tafalla Luna
No ratings yet
Affidavit of Loss: Jay Christopher Tafalla Luna
1 page
Affidavit of Loss - Passsport
No ratings yet
Affidavit of Loss - Passsport
1 page
Republic of The Philippines) City of Davao) X
No ratings yet
Republic of The Philippines) City of Davao) X
1 page
Affidavit of Loss of Passport
No ratings yet
Affidavit of Loss of Passport
1 page
Affidavit of Loss Passport
No ratings yet
Affidavit of Loss Passport
1 page
Affidavit of Destruction/Mutilation of Passport: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 24
No ratings yet
Affidavit of Destruction/Mutilation of Passport: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 24
1 page
Affidavit of Loss: Republic of The Philippines) Mandaue City) S.S
No ratings yet
Affidavit of Loss: Republic of The Philippines) Mandaue City) S.S
1 page
affidavit of loss - passport CYNTHIA CENTENO
No ratings yet
affidavit of loss - passport CYNTHIA CENTENO
1 page
Affidavit of Loss - Dfa
No ratings yet
Affidavit of Loss - Dfa
2 pages
Affidavit of Loss - Passport
No ratings yet
Affidavit of Loss - Passport
4 pages
Affidavit of Loss - Maluto Marivic
0% (1)
Affidavit of Loss - Maluto Marivic
1 page
Affloss Senior Atm Card From Landbank
No ratings yet
Affloss Senior Atm Card From Landbank
1 page
Republic of The Philippines) City of Pasig) S.S. X - X
No ratings yet
Republic of The Philippines) City of Pasig) S.S. X - X
18 pages
Affidavit of Loss: Affiant
No ratings yet
Affidavit of Loss: Affiant
1 page
AFFIDAVIT of Loss Passport: Doc. No. 170 Page No. 35 Book No. 1 Series of 2009
No ratings yet
AFFIDAVIT of Loss Passport: Doc. No. 170 Page No. 35 Book No. 1 Series of 2009
1 page
Affidavit of Loss - Jenelyn Gabales
No ratings yet
Affidavit of Loss - Jenelyn Gabales
2 pages
Aff. Loss Baluis
No ratings yet
Aff. Loss Baluis
3 pages
Move Us 2 Panama
From Everand
Move Us 2 Panama
T. C. Boyle
No ratings yet
Affidavit of Loss - School Diploma
No ratings yet
Affidavit of Loss - School Diploma
1 page
AFFIDAVIT OF LOSS-BUSINESS DOCS
No ratings yet
AFFIDAVIT OF LOSS-BUSINESS DOCS
1 page
NO INCOME BUSINESS
No ratings yet
NO INCOME BUSINESS
1 page
petition of splitting
No ratings yet
petition of splitting
6 pages
AFFIDAVIT OF non tenancy no pending case
No ratings yet
AFFIDAVIT OF non tenancy no pending case
1 page
AFFIDAVIT OF FINANCIAL SUPPORT- laxamana
No ratings yet
AFFIDAVIT OF FINANCIAL SUPPORT- laxamana
1 page
FULL RETIREMENT GRAB
No ratings yet
FULL RETIREMENT GRAB
1 page
no income
No ratings yet
no income
27 pages
Explanation LTO
No ratings yet
Explanation LTO
182 pages
affidavit of legal capacity
No ratings yet
affidavit of legal capacity
1 page
SPA For Annulment
No ratings yet
SPA For Annulment
2 pages
Affidavit of Cohabitation-TEMPLATE
No ratings yet
Affidavit of Cohabitation-TEMPLATE
2 pages
Linksys Official Support - Getting To Know The Linksys EA8500 Max-Stream™ AC2600 Smart Wi-Fi Router
No ratings yet
Linksys Official Support - Getting To Know The Linksys EA8500 Max-Stream™ AC2600 Smart Wi-Fi Router
4 pages
Highway Engineering Gate Questions
No ratings yet
Highway Engineering Gate Questions
117 pages
cns4 1
No ratings yet
cns4 1
12 pages
S No. Companname Designa Phone Email No. of Ecity Stdcode
No ratings yet
S No. Companname Designa Phone Email No. of Ecity Stdcode
5 pages
Memory Is Another Country Women Of The Vietnamese Diaspora Illustrated Nathalie Huynh Chau Nguyen instant download
No ratings yet
Memory Is Another Country Women Of The Vietnamese Diaspora Illustrated Nathalie Huynh Chau Nguyen instant download
85 pages
Basic Maths and Calculus (Mathematical Tools) DPP 04 (of L
No ratings yet
Basic Maths and Calculus (Mathematical Tools) DPP 04 (of L
3 pages
Lecture 1 - Introduction To Financial Planning
No ratings yet
Lecture 1 - Introduction To Financial Planning
46 pages
Class 12 Computer Science Project
0% (1)
Class 12 Computer Science Project
30 pages
CE00092-ST-ABW-301 REV 0
No ratings yet
CE00092-ST-ABW-301 REV 0
1 page
cs604 Quiz
No ratings yet
cs604 Quiz
4 pages
1223 Class 6 Work Sheets 201910141824041223 Class 6 Work Sheets 20191014182404
No ratings yet
1223 Class 6 Work Sheets 201910141824041223 Class 6 Work Sheets 20191014182404
3 pages
Django MCQ3
No ratings yet
Django MCQ3
14 pages
Customer Telma MG Site Id: VAK065 Telma Madagascar Site Name: Anjazafotsy Delivery Adress: Anjazafotsy Tel: Tel: Fax Fax
No ratings yet
Customer Telma MG Site Id: VAK065 Telma Madagascar Site Name: Anjazafotsy Delivery Adress: Anjazafotsy Tel: Tel: Fax Fax
3 pages
Topic 6 7
No ratings yet
Topic 6 7
10 pages
Permastore-Uk-Ind-Brochure - Glassfused Steel Tanks
No ratings yet
Permastore-Uk-Ind-Brochure - Glassfused Steel Tanks
12 pages
3 Understanding Data
No ratings yet
3 Understanding Data
10 pages
Distressed Jeans For Womens
No ratings yet
Distressed Jeans For Womens
7 pages
BIM
No ratings yet
BIM
4 pages
A Comparison of Fake News Detecting and Fact-Checking AI Based Solutions
No ratings yet
A Comparison of Fake News Detecting and Fact-Checking AI Based Solutions
19 pages
Proforma Invoice: Zhuji Jiani Knitting & Textile Co.,Ltd
No ratings yet
Proforma Invoice: Zhuji Jiani Knitting & Textile Co.,Ltd
2 pages
Year 10 Drama: Methods of Deepening and Securing Knowledge
No ratings yet
Year 10 Drama: Methods of Deepening and Securing Knowledge
3 pages
Male Sterilization: Vasectomy
No ratings yet
Male Sterilization: Vasectomy
1 page
CBSE Class 9 Science The Fundamental Unit of Life MCQs
33% (3)
CBSE Class 9 Science The Fundamental Unit of Life MCQs
3 pages
ED-2002-005 32-Point 24 VDC Input Module (4632)
No ratings yet
ED-2002-005 32-Point 24 VDC Input Module (4632)
6 pages
CP CPK - PP PPK
No ratings yet
CP CPK - PP PPK
8 pages
Fractions Teacher
No ratings yet
Fractions Teacher
15 pages