REPUBLIC OF THE PHILIPPINES )

BIÑAN LAGUNA ) S.C.

AFFIDAVIT OF LOSS

I, ANALYN B. SORIANO, of legal age, Filipino and a residential address as

628-D Extremadura Street, Sampaloc, Manila, after having been duly sworn to
in accordance with law, hereby DEPOSE and STATE:

1. That issued in my favor by Professional Regulation Commission a

Professional Identification Card (PRC ID) bearing Registration No.
0002368;

2. That sometime in December 6, 2022, I was in need to show my PRC

ID. I pulled out my wallet where I usually safe keep my PRC ID and
other valuable identification cards, however, found out that the PRC
ID was not in my wallet. I tried searching at home and other places
where I usually place my valuable but the search was futile. Thus, my
PRC ID was deemed misplaced and lost, and despite earnest efforts to
locate it, the same proved futile;

3. That I am executing this affidavit to attest the veracity of the foregoing

facts to report the said loss of certificate and for whatever legal
purpose this may duly serve;

IN WITNESS WHEREOF, I have hereunto set my hand this ____________at

__________________________.

ANALYN B. SORIANO
Affiant

SUBSCRIBED AND SWORN to before me this ____________ at

__________________________, affiant exhibiting to me his Competent Evidence of
Identity with number __________________________.

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