Republic of the Philippines )

Davao City ) S.S

x---------------------------------------/

AFFIDAVIT OF LOSS

I, Yvesse Carlo G. Suan, of legal age, single, and a resident of USDA Dormitory,
Pelaez St., Cebu City, Cebu, after having been sworn to in accordance with law, do
hereby depose and say that:

1. In the last week of January, I went to Davao City to visit a friend;

2. While I was enjoying my stay there, I did not notice that I already lost my
wallet until I was about to leave for Cebu City

3. My wallet contained cash, cards and IDs, including my UMID;

4. Hence, I immediately retraced my steps to look for the same but despite
diligent effort, it could not be found;

6. I am executing this affidavit to attest to the truth of the foregoing and to request
for another UMID.

IN WITNESS WHEREOF, I hereunto affix my signature this 29 th day of January 2020 in

Davao City.

Yvesse Carlo G. Suan

Affiant

SUBSCRIBED AND SWORN to me this 29th day of January 2020 in Davao City,
Philippines, affiant exhibiting to me his competent evidence of identity written below his
name.

Doc No.: _____

Page No.: _____
Book No.: _____
Series of 2020
Republic of the Philippines )
Davao City ) S.S
x---------------------------------------/

AFFIDAVIT OF LOSS

I, Yvesse Carlo G. Suan, of legal age, single, and a resident of USDA Dormitory,
Pelaez St., Cebu City, Cebu, after having been sworn to in accordance with law, do
hereby depose and say that:

1. In the last week of January, I went to Davao City to visit a friend;

5. While I was enjoying my stay there, I did not notice that I already lost my
wallet until I was about to leave for Cebu City

6. My wallet contained cash, cards and IDs, including my Philhealth ID;

7. Hence, I immediately retraced my steps to look for the same but despite
diligent effort, it could not be found;

6. I am executing this affidavit to attest to the truth of the foregoing and to request
for another Philhealth ID.

IN WITNESS WHEREOF, I hereunto affix my signature this 29 th day of January 2020 in

Davao City.

Yvesse Carlo G. Suan

Affiant

SUBSCRIBED AND SWORN to me this 29th day of January 2020 in Davao City,
Philippines, affiant exhibiting to me his competent evidence of identity written below his
name.

Doc No.: _____

Page No.: _____
Book No.: _____
Series of 2020
Republic of the Philippines )
Davao City ) S.S
x---------------------------------------/

AFFIDAVIT OF LOSS

I, Yvesse Carlo G. Suan, of legal age, single, and a resident of USDA Dormitory,
Pelaez St., Cebu City, Cebu, after having been sworn to in accordance with law, do
hereby depose and say that:

1. In the last week of January, I went to Davao City to visit a friend;

8. While I was enjoying my stay there, I did not notice that I already lost my
wallet until I was about to leave for Cebu City

9. My wallet contained cash, cards and IDs, including my PAGIBIG Loyalty

Card;

10. Hence, I immediately retraced my steps to look for the same but despite
diligent effort, it could not be found;

6. I am executing this affidavit to attest to the truth of the foregoing and to request
for another PAGIBIG Loyalty Card.

IN WITNESS WHEREOF, I hereunto affix my signature this 29 th day of January 2020 in

Davao City.

Yvesse Carlo G. Suan

Affiant

SUBSCRIBED AND SWORN to me this 29th day of January 2020 in Davao City,
Philippines, affiant exhibiting to me his competent evidence of identity written below his
name.

Doc No.: _____

Page No.: _____
Book No.: _____
Series of 2020
Republic of the Philippines )
Davao City ) S.S
x---------------------------------------/

AFFIDAVIT OF LOSS

I, Yvesse Carlo G. Suan, of legal age, single, and a resident of USDA Dormitory,
Pelaez St., Cebu City, Cebu, after having been sworn to in accordance with law, do
hereby depose and say that:

1. In the last week of January, I went to Davao City to visit a friend;

11. While I was enjoying my stay there, I did not notice that I already lost my
wallet until I was about to leave for Cebu City

12. My wallet contained cash, cards and IDs, including my CASHCARD

(PAGIBIG loan);

13. Hence, I immediately retraced my steps to look for the same but despite
diligent effort, it could not be found;

6. I am executing this affidavit to attest to the truth of the foregoing and to request
for another CASHCARD (PAGIBIG loan).

IN WITNESS WHEREOF, I hereunto affix my signature this 29 th day of January 2020 in

Davao City.

Yvesse Carlo G. Suan

Affiant

SUBSCRIBED AND SWORN to me this 29th day of January 2020 in Davao City,
Philippines, affiant exhibiting to me his competent evidence of identity written below his
name.

Doc No.: _____

Page No.: _____
Book No.: _____
Series of 2020