REPUBLIC OF THE 

PHILIPPINES)
Province of Leyte             ) S.S.
Municipality of Javier )
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AFFIDAVIT

I, RESTITUTO M. PALAÑA, 62 years old, Filipino, married, and a resident of

Brgy. Rizal, Javier, Leyte, after having been duly sworn to in accordance with law,
depose and state THAT:

1. I am the same RESTITUTO M. PALAÑA who executed an Affidavit

denominated as Doc. No. 301; Page No. 62; Book No. X; Series of 2022 in
the Notarial Register of Atty. Eden Jerby C. Go notarized on October 21,
2022 at Javier, Leyte;

2. I am the same CRISTITUTO PALAÑA as appearing in the Certificate of

Birth of my son CRISTITO VILLAMOR PALAÑA;

3. My true and correct name is RESTITUTO M. PALAÑA as appearing in my

Senior Citizen Identification Card and all other public records.

4. The said TIN Card has been in my possession and I placed it in my wallet
for safekeeping;

5. However, three months ago on May 28, 2022, I have noticed that my TIN
Card was no longer inside my wallet and probably have misplaced the
same;

6. For the past three months, I tried to find and locate said TIN Card but
despite diligent search and efforts, I could not find it such that I now
declare it lost beyond recovery;

7. I tried to ask my household member if they have seen it but all answered
in the negative;

8. I am executing this affidavit to attest to the veracity of my statements in

support of my request for the issuance of a new TIN Card and for
whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 31st day of

August 2022 at Javier, Leyte, Philippines.

ERNEST DANIEL P. MABALLO

Affiant
PhilSys ID No. 3015-4189-4653-8710
 SUBCRIBED AND SWORN TO before me this 31st day of August 2022 in
Javier, Leyte, Philippines, affiant exhibiting to me his competent evidence of identity
as indicated below his name.

Doc. No. _____;

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