Republic of the Philippines)

City of Zamboanga )s.s.

X-----------------------------------X

AFFIDAVIT OF LOSS

I, __________, of legal age, Filipino citizen and a resident of _______City,

Philippines, after having been duly sworn to in accordance with the law, hereby depose
and say that:

1. I am the owner of a Professional Regulation Commission Identification Card (PRC

ID) with a registration number______;

2. On April 29, 2023, I booked a Cebu Pacific flight, and on the very same day, I left
for Manila;

3. Upon arriving at the place where I will temporarily reside, I noticed that the said
PRC ID was no longer inside my pocket.

4. I exerted diligent efforts to locate the said PRC in my other belongings but all such
endeavors proved futile;

5. For all intents and purposes, I am now declaring the above-mentioned PRC ID to
be lost and beyond recovery and I execute this Affidavit to attest to the veracity of
the foregoing facts based on my personal knowledge and authentic records and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 18 th day of July at

Zamboanga City, Philippines.

_______________
Affiant
PRC ID NO. ____

SUBSCRIBED AND SWORN to before me on this 18 th day of July 2023 in the

City of______________.

Doc. No.
Page No.
Book No.
Series of 2023