Republic of the Philippines )

Province of Isabela ) S. S.
___________________ )
x------------------------------------x

AFFIDAVIT OF LOSS

I, FELICIANO O. TURINGAN III, of legal age, Filipino and a resident of San Fermin,
Cauayan City, Isabela, after having been duly sworn to in accordance with the law, hereby
depose and say that:

1. I am the very same person executing this affidavit;

2. I am the owner of a PHILIPPINE PASSPORT issued by Department of Foreign

Affairs (DFA) Tuguegarao City, Cagayan;

3. Sometime on July 2022, while I was riding my motorcycle on my way home, my

pouch-wallet got lost including the abovementioned passport;

4. I exerted my best effort to locate the said PHILIPPINE PASSPORT issued by

Department of Foreign Affairs (DFA) Tuguegarao City but all my efforts were in vain;

5. The said PHILIPPINE PASSPORT is now considered lost and beyond recovery;

6. I am executing this affidavit to attest to the truth of the foregoing for whatever
lawful purpose that it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of ____________,
2021 in ______________, Isabela.

FELICIANO O. TURINGAN III

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of _____________, 2022 in

City of Ilagan, Isabela with affiant exhibited to me his ________________ with ID No:
____________________.

Doc No. _____;

Page No. _____;
Book No. _____;
Series of 2022.