Republic of the Philippines ) s.s.

CITY OF ILIGAN )

AFFIDAVIT OF LOSS

I, EVELYN P. YUGYO, of legal age, Filipino, single parent and a resident

of Purok Isla Verda, Abuno, Iligan, after having been duly sworn to an oath in
accordance with law, deposes and states:

That I am a member of 4 P’s and holder of 4 P’s identification card

issued in my name by the Department of Social Welfare Development (DSWD)
Office of Lanao del Norte;

That the above-mentioned cards were among the documents which I

placed inside my envelop;

That sometime on May 10, 2018, while I was in Iligan City I brought with
my envelop which contained my 4 P’s identification card and other important
documents, when I reached home I noticed that my 4 P’s identification card
was no longer in my the brown envelop where I placed the same;

That I exerted all effort to locate the said 4 P’s ID Card, but the same
could no longer be found and is beyond recovery; hence considered lost for all
intents and purposes;

That I am executing this affidavit to attest to the truth of the foregoing

facts and for whatever legal purpose this may validly serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 19 th day of July

2018 at Iligan City, Philippines.

EVELYN P. YUGYO
Affiant
ID No. ____________

SUBSCRIBED and SWORN to before me this 19 th day of July, 2018 at

Iligan City. Affiant exhibited to me her Brgy ID No. 351, issued by Barangay
Abuno, Iligan City.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2018