REPUBLIC OF THE PHILIPPINES)

CITY
O F D AV AO
) SS.

AFFIDAVIT OF LOSS
I, REYNALDO P. ALBA, of legal age, Filipino, widow and a resident of
Purok Daisy, Visayan Village, Tagum City, under oath states that:
1.
I am a holder of a Philippine Passport issued by the Department of
Foreign Affairs, Davao City;
2.
I placed my passport among my personal files in my residence but
my said passport has been lost or misplaced;
3.
vain; and

I exerted diligent efforts to locate the same but all my efforts were in

4.
I am executing this affidavit to attest to the truth of the foregoing
narration of facts and for the purpose of issuing to me a new passport in lieu of
the lost one.
IN WITNESS WHEREOF, I have hereunto
________________ at Davao City, Philippines.

set

my

hand

this

REYNALDO P. ALBA
Affiant

SUBSCRIBED AND SWORN to before me this __________________ at

Davao City, Philippines, affiant exhibiting to me his Drivers License No. M06-83013375 as his competent evidence of identity.

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AFFIDAVIT OF LOSS

REPUBLIC OF THE PHILIPPINES)

CITY
O F DAVAO
) SS.
I, JOY A. ALUBA, of legal age, Filipino, single and a resident of Phase 4, Blk. 14,
Lot 10, Mimisa Road, Woodridge Ma-a, Davao City, under oath states that:
1.
I am the mother of JO ANNA ATASHA A. ALUBA, who was issued
Philippine Passport on 21 May 2009 and expiring on 20 May 2014 by the Department of
Foreign Affairs-Davao City, Philippines with passport No. XX3766853;
2.
Sometime on February 2009 the passport of my daughter was processed
by a travel agency for Korean visa. However, the said passport has been lost or
misplaced by the travel agency;
3.
I and the travel agency exerted diligent efforts to locate the same but all
our efforts were in vain;
4.
I am executing this affidavit to attest to the truth of the foregoing narration
of facts and for purposes of complying with the requirements of the DFA.
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of August
2012 at Davao City, Philippines.

JOY A. ALUBA
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of August 2012 at

Davao City, Philippines, affiant exhibiting to me her Non-Prof. Drivers License No. L0204-175712, issued at Davao City.

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