Republic of the Philippines)

Province of Cebu------------)
City of ___________________)

AFFIDAVIT OF LOSS

I, ________________________, Filipino, single, of legal age, a resident of

Barangay ________________________, after having been duly sworn to in
accordance with law, do hereby depose and state:

1. That I am a holder and owner of Driver’s License, Voter’s I.D. and

UMID I.D. which were issued to me by the LTO, COMELEC and GSIS
respectively. These items were always placed inside in my pocket;

2. That the aforestated License and I.D.s inadvertently got lost on May
01, 2021 after I noticed that my wallet was no longer in my pocket
when I arrived home in the afternoon of the said date;

3. That I exerted diligent effort to locate them but the same could no
longer be found;

4. That I declare that said Driver’s License, Voter’s I.D. and UMID I.D.
were totally lost beyond recovery;

5. That I execute this affidavit to attest the veracity of the foregoing

statement.

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

_______________ 2021 at __________________, Cebu, Philippines.

_________________________
Affiant

SUBSCRIBED AND SWORN to before me this ______ day of

________________ 2021, at __________________, Cebu, Philippines.
Republic of the Philippines)
Province of Cebu------------)
City of ___________________)

AFFIDAVIT OF LOSS

I, ALFRED ARREGLADO ALFEREZ, Filipino, single, of legal age,

presently residing in Barangay Bonbon, Aloguinsan Cebu, after having been
duly sworn to in accordance with law, do hereby depose and state:

1. That I am a holder and owner of a Philippine PASSPORT which was

issued to me by the Department of Foreign Affairs (DFA) on February
28, 2020;

2. That sometime on September 19, 2022, I went back to our residential

house located in Barangay Pakigne, Minglanilla, Cebu. I remembered
at that time that I brought with me a backpack and placed inside it
some items, my dress, including said PASSPORT;

3. That I noticed when I arrived in our residential house in Minglanilla,

my PASSPORT was no longer there. I was just thinking that maybe I
forgot it to placed inside my backpack and placed it somewhere;

4. That when I went back eventually into our house in Barangay

Bonbon, Aloguinsan. I tried to look hard my PASSPORT therein since
it was very important for me;

5. That I exerted diligent effort to locate it but the same could no longer
be found. Hence, I declared that the same was totally lost and could
no longer be recovered;

6. That I execute this affidavit to attest the veracity of the foregoing

statement.

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

_______________ 2022 at ___________________, Cebu, Philippines.

ALFRED ARREGLADO ALFEREZ

Affiant

SUBSCRIBED AND SWORN to before me this ______ day of

________________ 2022, at __________________, Cebu, Philippines.