Republic of the Philippines )

Province of Negros Oriental ) s.s.

City of Dumaguete )

AFFIDAVIT OF LOSS

I, JUNE GRACE C. BUENVIAJE, of legal age, Filipino, and a resident of Brgy.

Bagacay, Dumaguete City, Negros Oriental, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state: That

1. I am a holder of several IDs’ namely: Postal ID, National ID and Vaccination

ID;

2. Last November 15, 2023 between 3:00 to 5:00 o’clock in the afternoon, while
traversing the road riding a tricycle for hire from NORSU Main to my
residence in Bagacay, Dumaguete City, I placed the above-mentioned IDs in
my wallet;

3. Upon arriving at my destination, I reached on my wallet to get some money for

the tricycle fare and walk towards my house;

4. Upon arriving at my house, I immediately reached my wallet;

5. To my surprise, the above-mentioned wallet where the IDs were placed was
missing;

6. I immediately tried to locate the said wallet by tracing back the route where I
passed by from the time I alighted from the tricycle going to my house but to
no avail;

7. Despite my earnest effort to find said wallet, I was not able to locate the same;

8. The above-mentioned IDs were not confiscated, cancelled nor revoked by any
Government Agency or any institution for violation of any law or rules and
regulations; and

9. I am executing this affidavit to attest to the truth of the foregoing facts and for
whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 20 th day of

November 2023, Dumaguete City, Negros Oriental, Philippine

JUNE GRACE C. BUENVIAJE

Affiant
ID No. _____
Issued by _________________

SUBSCRIBED AND SWORN to before me this 20th day of November 2023,

Dumaguete City, Negros Oriental, Philippines.
 Doc No.
Page No.
Book No.
Series of 2023.
EMMA D. ESTRABELA

WITNESS

WITNESS