Republic of the Philippines)

City of Davao, Davao del Sur) S.S.

x-------------------------------x

AFFIDAVIT OF LOSS

I, FLOREVA SATO REYES, Filipino, of legal age, single and a resident of

Santan St., Northern Plains Subd., Panabo City, Davao del Norte, Philippines,
after being duly sworn to in accordance with law, despose and state that:

1. As a Bonafede tax contributor of Bureau of Internal Revenue (BIR) of the

Philippines, I was issued a Tax Identification Number (TIN) identification card,
with No. 483-464-997;

2. On or about year 2018, when I traveled to Cebu for vacation, I discovered

that my TIN ID was missing and I exerted all efforts to locate the same but I
could no longer find it;

3. Said TIN ID has not been confiscated by any officer of the law or by the
officers of BIR for violation of any law, ordinance, decree of the rules and their
regulations;

4. As all diligent search and efforts to find the same proved futile, it is now safe
to assume that said TIN ID is now lost beyond recovery;

5. As such, I execute this affidavit to attest to the truth of the foregoing facts, to
support my application for the issuance of a new TIN ID, and for whatever legal
purpose that this affidavit may serve.
 IN WITNESS WHEREOF, I have set my hand this 20thday of August
2020 in Davao City, Philippines.

FLOREVA SATO REYES

Affiant

SUBSCRIBED AND SWORN to before me this

_______________________, affiant exhibiting his/her Philippine Passport valid
until the 24th day of April 2020 and issued at Davao City, Philippines.

Doc. No. _______________;

Page No. _______________;
Book No. _______________;
Series of _______________;