REPUBLIC OF THE PHILIPPINES )

PROVINCE OF PAMPANGA ) S.S

CITY OF SAN FERNANDO )

AFFIDAVIT OF LOSS
I, KRISTINE ANN MENDOZA y DE SAN JOSE, Filipino, of legal
age, single, and resident of Magdalena Subd., San Juan, City of San
Fernando, Pampanga, after being duly sworn in accordance with law,
depose and state that:

1. I am a bona fide Solo Parent, having qualified to be one in

accordance with pertinent laws;

2. As proof of such fact, I was issued an ID, which I would regularly

use;

3. Sometime this June 2020, I applied for an aid for solo parents. As
such, one requirement is the Solo Parent ID;

4. It was only then that I realized that I could not locate my ID;

5. Despite diligent search and efforts to locate the said ID, I could
not find the same, such that I believe that it is now lost beyond recovery;

6. As such, I am executing this Affidavit of Loss to attest to the truth

of the foregoing and for any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

th
26 of June 2020 in the City of San Fernando, Pampanga.

KRISTINE ANN D. MENDOZA

Affiant

SUBSCRIBED AND SWORN to before me this 26th day of June 2020

in the City of San Fernando, Pampanga, the affiant exhibiting to me her
Fernandino Card with ID No. 11810-0378 as competent proof of her
identity.