Republic of the Philippines)

Province of Zambales
City of Olongapo)
x-----------x

AFFIDAVIT OF LOSS

I, Lea Ann T. Fernandez, Filipino, of legal age, single and a resident of 1426
Tabacuhan Sta. Rita, Olongapo City, Philippines, after being duly sworn to in
accordance with law, hereby depose and state:

That I am an employee of SC Megaworld Construction and Development

Corporation at #1 Philip St. Multinational Village, Philippines and at the same time
a holder of BDO ATM Card;

That on April 28, 2019 at around 2 o’clock in the afternoon, while I was at the market
of San Antonio Bayan at Olongapo City Province of Zambales, I lost my wallet
which I usually place in my back pocket;
That inside the said wallet is my ATM Card issued by BANCO DE ORO (BDO)
Bank, Bicutan Branch Paranaque City;
That despite diligent search and efforts to locate the said wallet and my ATM Card,
I could not find them such that I now believe that they are now lost beyond recovery;
As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support my application for the issuance of a new ATM Card, in lieu of the
ones that were lost.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at

_______________________, Philippines.

LEA ANN T. FERNANDEZ

Affiant

SUBSCRIBED AND SWORN to before me this _______________at

_______________affiant _____________________personally appeared before me
and exhibited to me BDO ATM Card and is valid until______________.

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