REPUBLIC OF THE

PHILIPPINES )
CITY OF QUEZON ) S.S.
AFFIDAVIT OF LOSS
I, Adrian P. Mangaoang, Filipino,
of legal age, single and a resident
of 14B Ledesma Court, Culiat,
Tandang Sora, Quezon City, after
having duly sworn to in
accordance with law, hereby
depose and say
that:
1. I am a holder of a Certified
Public Accountant Identification
Card issued by Professional
Regulation
Commission;
2. I lost said Identification Card
on May 10, 2011 and that I
exerted all efforts to locate the
same but I
could not remember exactly
where I placed it and it is
considered lost for all legal
purposes;
3. Said Identification Card was
not confiscated by any officer of
the law by reason of any
violation of
any law, ordinance, presidential
decree or rules and regulation of
the said Commission; and
neither was it offered as collateral
for any loan;
 I am executing this affidavit to
attest to the foregoing facts;
IN WITNESS WHEREOF, I have
hereunto set my hand this 13
th
of May in the City of Quezon,
Philippines.
ADRIAN P. MANGAOANG
Affiant
SUBSCRIBED AND SWORN to
before me this _______________
in the City of __________,
Philippines,
affiant having exhibited to me
his/her community tax certificate
with no. __________________
issued
on _________________ at
______________ .
Doc. No. ________;
Page No. ________;
Book No.________;
Series of 2011.

REPUBLIC OF THE
PHILIPPINES )
CITY OF QUEZON ) S.S.
AFFIDAVIT OF LOSS
I, Adrian P. Mangaoang, Filipino,
of legal age, single and a resident
of 14B Ledesma Court, Culiat,
Tandang Sora, Quezon City, after
having duly sworn to in
accordance with law, hereby
depose and say
that:
1. I am a holder of a Certified
Public Accountant Identification
Card issued by Professional
Regulation
Commission;
2. I lost said Identification Card
on May 10, 2011 and that I
exerted all efforts to locate the
same but I
could not remember exactly
where I placed it and it is
considered lost for all legal
purposes;
3. Said Identification Card was
not confiscated by any officer of
the law by reason of any
violation of
any law, ordinance, presidential
decree or rules and regulation of
the said Commission; and
neither was it offered as collateral
for any loan;
I am executing this affidavit to
attest to the foregoing facts;
IN WITNESS WHEREOF, I have
hereunto set my hand this 13
th
of May in the City of Quezon,
Philippines.
ADRIAN P. MANGAOANG
Affiant
SUBSCRIBED AND SWORN to
before me this _______________
in the City of __________,
Philippines,
affiant having exhibited to me
his/her community tax certificate
with no. __________________
issued
on _________________ at
______________ .
Doc. No. ________;
Page No. ________;
Book No.________;
Series of 2011.

REPUBLIC OF THE
PHILIPPINES )
CITY OF QUEZON ) S.S.
AFFIDAVIT OF LOSS
I, Adrian P. Mangaoang, Filipino,
of legal age, single and a resident
of 14B Ledesma Court, Culiat,
Tandang Sora, Quezon City, after
having duly sworn to in
accordance with law, hereby
depose and say
that:
1. I am a holder of a Certified
Public Accountant Identification
Card issued by Professional
Regulation
Commission;
2. I lost said Identification Card
on May 10, 2011 and that I
exerted all efforts to locate the
same but I
could not remember exactly
where I placed it and it is
considered lost for all legal
purposes;
3. Said Identification Card was
not confiscated by any officer of
the law by reason of any
violation of
any law, ordinance, presidential
decree or rules and regulation of
the said Commission; and
neither was it offered as collateral
for any loan;
I am executing this affidavit to
attest to the foregoing facts;
IN WITNESS WHEREOF, I have
hereunto set my hand this 13
th
of May in the City of Quezon,
Philippines.
ADRIAN P. MANGAOANG
Affiant
SUBSCRIBED AND SWORN to
before me this _______________
in the City of __________,
Philippines,
affiant having exhibited to me
his/her community tax certificate
with no. __________________
issued
on _________________ at
______________ .
Doc. No. ________;
Page No. ________;
Book No.________;
Series of 2011.
REPUBLIC OF THE PHILIPPINES )
CITY OF VALENZUELA ) S.S.

AFFIDAVIT OF LOSS

I, ________________, Filipino, of legal age, and a resident of

_________________________, after having duly sworn to in accordance with
law, hereby depose and say that:

1. I am the owner/holder of SSS ID with number _______________ and

TIN ID __________________ issued by Social Security System (SSS)
and Bureau of Internal Revenue (BIR), respectively;
2. That sometime on 2017, I noticed that the wallet where I used to place
my SSS and TIN ID was missing, and same might have misplaced,
fallen or without my knowledge when I was traveling home from
work;
3. That despite after having exerted all efforts to locate the same, I could
not find it and it is now considered lost for all legal purposes and
beyond recovery;
4. Said SSS and TIN IDs were not confiscated by any officer of law by
reason of any violation of any law, ordinance, or rules and regulation
of any agency or government instrumentality;
5. I am executing this affidavit to attest to the foregoing facts for the
replacement of my SSS and TIN IDs and for whatever legal purposes it
may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this

___________________ in the _________________, Philippines.

________________________
 Affiant
_______________________

SUBSCRIBED AND SWORN to before me this ____________ in the

_______________________, Philippines, affiant having exhibited to me his
above-stated ID.

Notary Public
Doc No.
Page No.
Book No.
Series of 2022