REPUBLIC OF THE PHILIPPINES )

CITY OF DAVAO ) S.S.

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

JOINT AFFIDAVIT OF LOSS

We, XXX, and XXX, of legal age, married, Filipinos, and residents of XXX, after having
been duly sworn to in accordance with law hereby depose and state that:

1. We maintain a joint account with Banco De Oro Unibank, Inc. (BDO) XXX Branch,
Davao City with Account No. XXX with which we were also issued a Passbook;

2. We kept the said Passbook at our house together with some other important
documents;

3. Sometime on 2022, when we were about to locate the said Passbook, we could no
longer find it and until now, the same Passbook was not found;

4. Despite diligent efforts to search for the Passbook, the same could no longer be
located leading me to believe that the same is already lost;

5. In the event that the lost Passbook should hereafter be found or located, we
undertake to forward or surrender the same to BDO for appropriate disposal;

6. We are executing this affidavit to attest to the truth of the foregoing and for the
purpose of requesting for a replacement of the said Passbook.

IN WITNESS WHEREOF, we have hereunto set our hand this ________________ at

Davao City, Philippines.

XXX XXX
Affiant Affiant

SUBSCRIBED AND SWORN TO before me this _______________ at Davao City,

Philippines, affiants exhibiting to me the following:
 COMPETENT EVIDENCE OF IDENTITY
AFFIANTS ID Number and Expiry Date
Type of ID
(if applicable)
XXX 1

XXX
2

Doc No. ____;

Page No.____;
Book No. ___;
Series of 2022