Republic of the Philippines ))

City of Calbayog )) s.s.

AFFIDAVIT OF LOSS
I, ALICIA P. ESCORIDO, Filipino, 78 years of age, widow, and a
resident of Barangay Napuro, Sta. Margarita, Samar, Philippines, after having been duly
sworn to in accordance with law, hereby depose and state, that--

1. I am a holder of a Metro Rewards Card from Metro Mall Calbayog City, Samar.
But its card Number I can no longer recall;

2. Sometime this week, while travelling, I lost the same card together with my
other cards inside my wallet, without my knowledge;

3. The moment I learned of its loss, I exerted diligent efforts to locate the same,
but to no avail;

4. I am executing this Affidavit to attest to the truth of the foregoing facts and to
to support my application for the issuance of a new Metro Rewards Card from
Metro Mall and for whatever legal purpose this may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of November
2019, at Calbayog City, Philippines.

ALICIA P. ESCORIDO
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this this 7th day of November
2019, at Calbayog City, Philippines.

ATTY. ALJUN B. DIAZ

Public Attorney I
Pursuant to RA 9406

1
Republic of the Philippines ))
City of Calbayog )) s.s.

AFFIDAVIT OF LOSS
I, IBARRA TIBO SALURIO, Filipino, 28 years of age, and a resident of Barangay
Basud, Calbayog City, Samar, Philippines, after having been duly sworn to in accordance
with law, hereby depose and state, that--

1. I am presently connected with the Armed Forces of the Philippines as a Private

First Class Enlisted Personnel since April 2016, and is based in 53rd Engr.
Brigade, PA;

2. As such, I was issued a Military Identification Card, but its Reference Number,
I can no longer recall;

3. Sometime this week, while travelling, I lost the same card together with my
other cards inside my wallet, without my knowledge;

4. The moment I learned of its loss, I exerted diligent efforts to locate the same,
but to no avail;

5. I am executing this Affidavit to attest to the truth of the foregoing facts and to
to support my application for the issuance of a new Military Identification Card
from the Philippine Army and for whatever legal purpose this may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 6th day of April
2018, at Calbayog City, Philippines.

IBARRA TIBO SALURIO

Affiant
VIN: 6003-0045B-G1989ITS10000-3

SUBSCRIBED AND SWORN TO BEFORE ME, this 6th day of April 2018, at
Calbayog City, Philippines.

ATTY. ALJUN B. DIAZ

Public Attorney I
Pursuant to RA 9406

Doc. No. 17
Page No. 1;
Book No. I
Series of 2018