REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, KENDRA MAE D. ROJAS, of legal age, married, Filipino Citizen and a

resident of Centro, Lal-lo, Cagayan, after having been duly sworn to in accordance
with law, hereby deposes and says:

1. That I am a holder/possessor of the following items, to wit:

a. PhilHealth Identification Card;

b. National Identification Card;
c. 8,000 pesos cash.

2. That sometime on November 2023, I lost a black wallet;

3. That the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;

4. That despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid items, the same, however, proved futile;

5. That the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

6. That I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 1st day of

February 2024 at Aparri, Cagayan.

KENDRA MAE D. ROJAS

Affiant

SUBSCRIBED AND SWORN to before me this 1st day of February 2024 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Page No. ___; Until December 31, 2024
Roll of Attorney No. 25108
Book No. XXIII; P.T.R. No. 12875739
Series of 2024. Issued on January 2, 2024
Series of 2023. Issued at Aparri, Cagayan
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, ROLLY V. TOBIAS, of legal age, Filipino Citizen and a resident of Sta.

Cruz, Sta. Ana, Cagayan, after having been duly sworn to in accordance with law,
hereby deposes and says:

7. That I am a holder/possessor of the following items, to wit:

d. Professional Driver’s License;

e. National Identification Card;
f. SSS Identification Card;
g. PagIbig Identification card;
h. PhilHealth Identification card and;
i. TIN Identification card.

8. That the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;

9. That despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid items, the same, however, proved futile;

10. That the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;

11. That I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of

December 2023 at Aparri, Cagayan.

ROLLY V. TOBIAS
CRN No. 021-1398-4102-9
Affiant

SUBSCRIBED AND SWORN to before me this 29th day of December 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Page No. ___; Until December 31, 2024
Roll of Attorney No. 25108
Book No. XXII P.T.R. No. 12777828
Series of 2023; Issued on January 3, 2023
Series of 2023. Issued at Aparri, Cagayan
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT

I, NENITA TUMALIUAN LOPENA, of legal age, widow, Filipino

Citizen and a resident of Zone 4, Naddungan, Gattaran, Cagayan, after having been
duly sworn to in accordance with law, hereby deposes and says:

12.That the particulars stated in the legal heir certificate dated on

November 30,2023, enclosed herewith, are tru and correct to be the
best of my knowledge and information;

13.That I am only legally wedded wife of late Cristetimo Alano

Lopena;

14.That I am entitled to receive on behalf of the legal heirs, the Death

Benefits provided by the Company End of Service Benefits as
Gratuity, Insurance Money and other Compensations, as the legal
heirs of late Cristetimo Alano Lopena’s siblings:

1. Crispin Alano Lopena

2. Carlito Alano Lopena
3. Rodolfo Alano Lopena
4. Jorge Alano Lopena
5. Cirilo Alano Lopena

15.That Cristetimo Alano Lopena’s siblings have already established

that they have no objection in this regard;

16.That I am willing to pay their proportionate shares of the benefits to

my deceased husband’s siblings and legal heirs, if they so demand in
future;

17.That I will use the above-mentioned benefits in proportion to their

shares in the same for the upliftment and welfare of family and to
take care of my husband’s siblings;

18.That in the event that any other legal heir makes claim of the
benefits in the future, I will pay off the same in the proportion to
which they are entitled.
 19.That I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4 th day of

December 2023 at Aparri, Cagayan.

NENITA TUMALIUAN LOPENA

National Id No. 6421-9371-3246-9581
Affiant

SUBSCRIBED AND SWORN to before me this 4th day of December 2023

at Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XXI
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, BILLMAR A. FREEMAN JR., of legal age, single, Filipino Citizen and a

resident of Macanaya, Aparri, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

20. That I am a holder/possessor of the following items, to wit:

j. Professional Driver’s License;

k. Land Bank ATM Card;
l. Government Identification Card; and;
m. PhilHealth Identification card and;
n. Cash worth Php3, 600.00.

21. That the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;

22. That despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid items, the same, however, proved futile;

23. That the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
 24. That I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 16 th day of

October 2023 at Aparri, Cagayan.

BILLMAR A. FREEMAN JR.

Affiant

SUBSCRIBED AND SWORN to before me this 10th day of October 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Page No. ___; Until December 31, 2024
Roll of Attorney No. 25108
Book No. XX P.T.R. No. 12777828
Series of 2023; Issued on January 3, 2023
Series of 2023. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

We, OLIVIA R. CONCEPCION, LILYBETH B. LUCAS, JOCELYN

A. ABUYUAN INDEPENDENCIA M. CASILIAN, all of legal ages, Filipino
Citizens and a residents of Tallungan, Aparri, Cagayan, after having been duly
sworn to in accordance with law, hereby deposes and says:

25.That we are the member of Philippine Public School Teacher

Association(PPSTA) and we issued a New Mutual Retirement
Benefits System (NMRBS) Membership Certificate;

26.That the aforesaid Membership Certificate was missing and

consequently lost under circumstance beyond my control;

27.That despite diligent efforts on my part to locate and retrieve the

said Membership Certificate, the same, however, proved futile;

28.That the aforesaid Membership Certificate were never confiscated

by any lawful authorities nor lent to anybody;

29.That we are executing this affidavit to attest the truthfulness of all

the foregoing facts and for whatever legal intent and purpose this
may serve.
 IN WITNESS WHEREOF, we have hereunto set our hands this
_________________ at Aparri, Cagayan.

OLIVIA R. CONCEPCION LILYBETH B. LUCAS

Affiant Affiant

JOCELYN A. ABUYUAN INDEPENDENCIA M.

CASILIAN
Affiant Affiant

SUBSCRIBED AND SWORN to before me this _______________at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XX
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, LLOYD P. PALIUANAN, of legal age, single, Filipino Citizen and a

resident of Centro 4, Aparri, Cagayan, after having been duly sworn to in accordance
with law, hereby deposes and says:

30. That I am a holder/possessor of the following items, to wit:

o. Professional Driver’s License;

p. Land Bank ATM Card;
q. GCASH ATM Card; and;
r. Key

31. That on August 9,2023, the aforesaid wallet was missing and
consequently lost under circumstance beyond my control;

32. That despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid items, the same, however, proved futile;

33. That the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
 34. That I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 10 th day of

August 2023 at Aparri, Cagayan.

LLOYD P. PALIUANAN
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of August 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Page No. ___; Until December 31, 2024
Roll of Attorney No. 25108
Book No. XIX P.T.R. No. 12777828
Series of 2023; Issued on January 3, 2023
Series of 2023. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, MICHAEL JOHN IBAÑEZ, of legal age, single, Filipino Citizen and a

resident of Amulung, Cagayan, after having been duly sworn to in accordance with
law, hereby deposes and says:

35. That I am a holder/possessor of the following items, to wit:

s. UMID Identification Card;

t. PRC Identification Card;
u. Company Identification Card;
v. Land Bank ATM Card;
w. Banco De Oro(BDO) ATM Card;
x. BPI ATM Card;
y. Bangkok Bank ATM Card; and;
z. Cash worth Php4,000.00 plus

36. That on August 7, 2023, the aforesaid wallet was missing and
consequently lost under circumstance beyond my control;

37. That despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid items, the same, however, proved futile;
 38. That the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;

39. That I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of

August 2023 at Aparri, Cagayan.

MICHAEL JOHN IBAÑEZ

Affiant

SUBSCRIBED AND SWORN to before me this 8th day of August 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Page No. ___; Until December 31, 2024
Roll of Attorney No. 25108
Book No. XIX P.T.R. No. 12777828
Series of 2023; Issued on January 3, 2023
Series of 2023. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, JOANNA B. ALMOJUELA, of legal age, single, Filipino Citizen and a

resident of Punta, Aparri, Cagayan, after having been duly sworn to in accordance
with law, hereby deposes and says:

40.That I am a holder/possessor of the following items, to wit:

aa. Philippine National Bank(PNB) ATM Card;

bb.Banco De Oro(BDO) ATM Card;
cc. Banco De Oro(BDO) Cash card, and;
dd.Cash worth Php150.00

41.That the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;

42.That despite diligent efforts on my part to locate and retrieve the

said wallet including the aforesaid items, the same, however, proved
futile;
 43.That the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;

44.That I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of

July 2023 at Aparri, Cagayan.

JOANNA B. ALMOJUELA
Affiant

SUBSCRIBED AND SWORN to before me this 13th day of July 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XIX
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, JANET A. SAMONTE, of legal age, married, Filipino Citizen and a

resident of Centro, Lallo, Cagayan, after having been duly sworn to in accordance
with law, hereby deposes and says:

45.That I am a holder/possessor of the following items, to wit:

ee. Phil Health Identification card ;

ff. Land Bank ATM Card;
gg.Professional Regulatory Commission(PRC) License;
hh.Voter’s Identification Card, and;
ii. Passbook;

46.That, on June 28, 2023, the aforesaid bag was missing and
consequently lost under circumstance beyond my control;
 47.That, despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

48.That, the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

49.That, I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 30 th day of

June 2023 at Aparri, Cagayan.

JANET A. SAMONTE
Affiant

SUBSCRIBED AND SWORN to before me this 30th day of June 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XIX
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, GLENDA I. PARAGGUA, of legal age, married, Filipino Citizen and a

resident of San, Antonio, Aparri, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

50.That I am a holder/possessor of the following items, to wit:

jj. Non-Professional Driver’s License;

kk.National Identification Card and;
ll. Cash worth Php500.00

51.That the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;
 52.That despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

53.That the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

54.That I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 30 th day of

June 2023 at Aparri, Cagayan.

GLENDA I. PARAGGUA
Affiant

SUBSCRIBED AND SWORN to before me this 30th day of June 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XIX
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, LAILANI C. MARQUEZ, of legal age, married, Filipino Citizen and a

resident of Centro West, Sta. Teresita, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

55.That I am a holder/possessor of the following items, to wit:

mm. Professional Driver’s License and;

nn.SSS Identification Card.

56.That the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;
 57.That despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

58.That the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

59.That I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 14 th day of

June 2023 at Aparri, Cagayan.

LAILANI C. MARQUEZ
Affiant

SUBSCRIBED AND SWORN to before me this 14th day of June 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XIX
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, RICHELLE D. UNONGEN, of legal age, married, Filipino Citizen and a

resident of Sicalao, Lasam, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

60.That I was the signatory to an agreements between the undersigned

and Sicalao Integrated School for the school year 2020-2021 and
2021-2022;

61.That the aforesaid agreements was misplace and despite diligent

efforts on my part to locate and retrieve the said file including the
aforesaid documents, the same, however, proved futile;
 62.That, the aforesaid documents were never confiscated by any lawful
authorities nor lent to anybody;

63.That, I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 3 rd day of

April 2023 at Aparri, Cagayan.

RICHELLE D. UNONGEN
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of April 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XVIII
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, ARJAY R. BERBANO, of legal age, married, Filipino Citizen and a

resident of Pacac Caagaman, Aparri, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

64.That I am a holder/possessor of the following items, to wit:

oo.Professional Driver’s License;

pp.National Identification Card;
qq.Cebuana Card;
rr. Palawan Card, and;
ss. M Luiller Card.

65.That, on March 4, 2023, the aforesaid wallet was missing and

consequently lost under circumstance beyond my control;
 66.That, despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

67.That, the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

68.That, I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7 th day of

March 2023 at Aparri, Cagayan.

ARJAY R. BERBANO
Affiant

SUBSCRIBED AND SWORN to before me this 7th day of March 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XVII
Roll of Attorney No. 25108
Series of 2023; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, QUINTIN F. MODELO, of legal age, single, Filipino Citizen and a

resident of Mapulang Lupa, Valenzuela City, after having been duly sworn to in
accordance with law, hereby deposes and says:

69.That I am a holder/possessor of the following items, to wit:

tt. Non Professional Driver’s License;

uu.Phil health Identification Card;
vv.PagIbig Identification Card;
ww. Tin Identification Card;
xx.Receipts, and
yy.Cash worth 1000 Pesos.
 70.That, the aforesaid wallet was missing and consequently lost under
circumstance beyond my control;

71.That, despite diligent efforts on my part to locate and retrieve the

said wallet including the aforesaid items, the same, however, proved
futile;

72.That, the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

73.That, I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 27 th day of

February 2023 at Aparri, Cagayan.

QUINTIN F. MODELO
Affiant

SUBSCRIBED AND SWORN to before me this 27th day of February 2023

at Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XVI
Roll of Attorney No. 25108
I; P.T.R. No. 12777828
Series of 2023. Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, JANN LLOYD ROSENDO MIRAFUENTE, of legal age, single,

Filipino Citizen and a resident of Catotoran Sur, Camalaniugan, Cagayan, after
having been duly sworn to in accordance with law, hereby deposes and says:

74.That I am a Deck Cadet of Motor Tanker Gem and such I required

the following documents, to wit:

zz. Fire Plan

aaa. Safety Plan;
 75.That, on February 02, 2023, the aforesaid documents was missing
and consequently lost under circumstance beyond my control;

76.That, despite diligent efforts on my part to locate and retrieve the

said documents, the same, however, proved futile;

77.That, the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

78.That, I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of

Fevruary 2023 at Aparri, Cagayan.

JANN LLOYD ROSENDO

MIRAFUENTE
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of February 2023

at Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XVII;
Roll of Attorney No. 25108
Series of 2023. P.T.R. No. 12777828
Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, GRETCHEN LIANE Q. UMENGAN, of legal age, single, Filipino

Citizen and a resident of Punta, Aparri, Cagayan, after having been duly sworn to
in accordance with law, hereby deposes and says:

79.That I am a holder/possessor of the following items, to wit:

bbb. Non Professional Driver’s License;

ccc. Phil health Identification Card;
 ddd. PNB Atm Card Savings; and
eee. PNB Atm Card Payroll.

80.That, on December 30, 2022, the aforesaid wallet was missing and
consequently lost under circumstance beyond my control;

81.That, despite diligent efforts on my part to locate and retrieve the

said wallet including the aforesaid items, the same, however, proved
futile;

82.That, the aforesaid items were never confiscated by any lawful

authorities nor lent to anybody;

83.That, I am executing this affidavit to attest the truthfulness of all the

foregoing facts and for whatever legal intent and purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 3 rd day of

January 2023 at Aparri, Cagayan.

GRETCHEN LIANE Q.
UMENGAN
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of January 2023 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2024
Book No. XVI;
Roll of Attorney No. 25108
Series of 2023. P.T.R. No. 12777828
Issued on January 3, 2023
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, RONALD G. TUMAMAO, of legal age, married, Filipino Citizen and a resident of

Tallunga, Aparri, Cagayan, after having been duly sworn to in accordance with law, hereby
deposes and says:

84. That I am a holder/possessor of the following items, to wit:

 fff. Expired Security Guard License;
ggg. Professional Driver’s License;
hhh. Security Guard License;
iii. National Identification Card;
jjj. Phil health Identification Card;
kkk. Xerox Copy of Motorcycle Registration;
lll. Xerox Copy of Oplan Visa Motorcycle; and
mmm. Seven Hundred Pesos (Php700.00) worth of money.

85. That, on November 22, 2022, the aforesaid wallet was missing and
consequently lost under circumstance beyond my control;

86. That, despite diligent efforts on my part to locate and retrieve the said wallet
including the aforesaid items, the same, however, proved futile;

87. That, the aforesaid items were never confiscated by any lawful authorities nor
lent to anybody;

88. That, I am executing this affidavit to attest the truthfulness of all the foregoing
facts and for whatever legal intent and purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 22 nd day of November

2022 at Aparri, Cagayan.

RONALD G. TUMAMAO
Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of November 2022 at Aparri,
Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Until December 31, 2022
Page No. ___; Roll of Attorney No. 25108
Book No. XVI; P.T.R. No. 11686327
Issued on January 3, 2022
Series of 2022. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, NYMPHA KRYZETTE UNCIANO, of legal age, married, Filipino Citizen

and a resident of Macanaya, Aparri, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

1. That I was employed as Sales Marketing Supervisor/Sales Agent 2 at St. Peter

Lifeplan Inc. from year 2012 to year 2017 and as such, I was issued a
Company Identification Card;
 2. That during my employment at the aforesaid Company, I acquired an
Automated Teller Machine (ATM) Card at Banco De Oro where my salary,
wages and other payments were deposited;

3. That, the aforesaid Company Identification Card and Automated Teller

Machine (ATM) Card which I put in my wallet was inadvertently misplaced
and consequently lost under circumstances beyond my control;

4. That, despite diligent efforts on my part to locate and retrieve the aforesaid
Company Identification Card and Automated Teller Machine (ATM) Card,
the same, however, proved futile;

5. That I am executing this affidavit to attest the truthfulness of all the foregoing
facts and in order to show proof of loss and for whatever other legal intent and
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7 th day of

September 2022 at Aparri, Cagayan.

NYMPHA KRYZETTE UNCIANO

Affiant

SUBSCRIBED AND SWORN to before me this 7th day of September 2022 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Until December 31, 2022
Page No. ___;
Roll of Attorney No. 25108
Book No. XV; P.T.R. No. 11686327
Series of 2022. Issued on January 3, 2022
Issued at Aparri, Cagayan
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, EVELYN SABUYAS SARCILLA, of legal age, married, Filipino Citizen and a

resident of Nagsirucan, Aparri West, Cagayan, after having been duly sworn to in accordance
with law, hereby deposes and says:

89. That I am a holder/possessor of the Payroll slip for the Month of May 2016
DEP-ED

90. That, in May 2017, the aforesaid Pay roll slip which I put inside my bag was
missing and consequently lost under circumstance beyond my control;

91. That, despite diligent efforts on my part to locate and retrieve the said Pay roll
slip the same, however, proved futile;
 92. That, I am executing this affidavit to attest the truthfulness of all the foregoing
facts and for whatever legal intent and purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day of June 2022 at
Aparri, Cagayan.

EVELYN SABUYAS SARCILLA

Affiant

SUBSCRIBED AND SWORN to before me this 17th day of June 2022 at Aparri,
Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Until December 31, 2022
Page No. ___; Roll of Attorney No. 25108
Book No. XIV; P.T.R. No. 11686327
Issued on January 3, 2022
Series of 2022. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, MARGARITA P. JERUSALEM, of legal age, single, Filipino Citizen and a resident

of Logac, Lallo, Cagayan, after having been duly sworn to in accordance with law, hereby
deposes and says:

93. That I am a holder/possessor of the following items, to wit:

nnn. UMID Identification Card;

ooo. TIN Identification Card;
ppp. PNB Atm Card
qqq. Senior Citizen Card and Booklet;
rrr. Claim Stab of PSA;
sss.SSS Identification Card;
ttt. Wallet;
uuu. Oppo A83; and
vvv. Ten Thousand Pesos (Php10,000.00) worth of money.

94. That, on November 16, 2019, the aforesaid items which I put inside my bag was
missing and consequently lost under circumstance beyond my control;

95. That, despite diligent efforts on my part to locate and retrieve the said bag
including the aforesaid items, the same, however, proved futile;

96. That, the aforesaid items were never confiscated by any lawful authorities nor
lent to anybody;
 97. That, I am executing this affidavit to attest the truthfulness of all the foregoing
facts and for whatever legal intent and purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of June 2022 at
Aparri, Cagayan.

MARGARITA P. JERUSALEM
Affiant

SUBSCRIBED AND SWORN to before me this 13th day of June 2022 at Aparri,
Cagayan.

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. ___; Notary Public
Until December 31, 2022
Page No. ___; Roll of Attorney No. 25108
Book No. XIV; P.T.R. No. 11686327
Issued on January 3, 2022
Series of 2022. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )
AFFIDAVIT OF LOSS

I, SOFIA C. COMILLAS, of legal age, single, Filipino Citizen and a resident of

Punta, Aparri, Cagayan, after having been duly sworn to in accordance with law, hereby
deposes and says:

98. That I am a holder/possessor of the following items, to wit:

www. Land Bank of the Philippines, ATM Card;
xxx. Philhealth ID Card
99. That, the aforesaid items which I put inside my wallet was missing and
consequently lost under circumstance beyond my control;

100. That, despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

101. That, the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
102. That, I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 8th day of June 2022
at Aparri, Cagayan.

SOFIA C. COMILLAS
 Affiant

SUBSCRIBED AND SWORN to before me this 8th day of June 2022 at Aparri,
Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2022
Book No. XIV;
Roll of Attorney No. 25108
Series of 2022. P.T.R. No. 11686327
Issued on January 3, 2022
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )
AFFIDAVIT OF LOSS

I, JEANER L. ARGONIA, of legal age, married, Filipino Citizen and a resident

of Magapit, Lal-lo, Cagayan, after having been duly sworn to in accordance with law,
hereby deposes and says:

103. That I am a holder/possessor of the following items, to wit:

yyy. Military Identification Card;
zzz. AFPSLAI Identification Card;
aaaa. PAFCIFIC Identification Card; and
bbbb. TIN Identification Card
104. That, on May 9, 2022, the aforesaid items which I put inside my
wallet was missing and consequently lost under circumstance beyond my
control;

105. That, despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

106. That, the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
107. That, I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 10 th day of May
2022 at Aparri, Cagayan.
 JEANER L. ARGONIA
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of May 2022 at Aparri,
Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2022
Book No. XIII;
Roll of Attorney No. 25108
Series of 2022. P.T.R. No. 11686327
Issued on January 3, 2022
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )
AFFIDAVIT OF LOSS

I, JEANER L. ARCONIA, of legal age, married, Filipino Citizen and a resident

of Magapit, Lal-lo, Cagayan, after having been duly sworn to in accordance with law,
hereby deposes and says:

108. That I am a holder/possessor of the following items, to wit:

cccc. Military Identification Card;
dddd. AFPSLAI Identification Card;
eeee. PAFCIFIC Identification Card; and
ffff. TIN Identification Card
109. That, on February 18, 2021, the aforesaid items which I put inside
my wallet was missing and consequently lost under circumstance beyond
my control;

110. That, despite diligent efforts on my part to locate and retrieve the
said wallet including the aforesaid items, the same, however, proved
futile;

111. That, the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
112. That, I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 25 th day of May
2021 at Aparri, Cagayan.

ANGELBERT B. BALBUENA
Affiant
 SUBSCRIBED AND SWORN to before me this 25th day of May 2021 at Aparri,
Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until June 30, 2021
Book No. IX;
SC B.M. No. 3795
Series of 2021. Roll of Attorney No. 25108
P.T.R. No. 10929412
Issued on January 4, 2021
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, UNIDO SALVADOR, of legal age, married, Filipino citizen and resident of Camiguin
Island, Calayan, Cagayan, after having been duly sworn to in accordance with law, hereby
deposes and says:

1. That I am the registered owner of a motor banca “ship” named as MB 3 Sisters II and
as such. I was issued by the authorities of the Philippine Coast Guard the
pertinentdocuments described as follows, to wit:

a. Certificate of Ownership
b. Certificate of Philippine Registry
c. Tonnage Measurement Certificate
d. Passenger Ship Safety Certificate
e. Minimum safe Manning Certificate
f. Bay and River License

2. That, the aforesaid pertinent documents which I put in one of my files was
inadvertently misplaced and consequently lost under circumstances beyond my
control;

3. That, despite diligent efforts on my part to locate and retrieve the said file including
the aforesaid documents, the same, however, proved futile;

4. That, the aforesaid documents were never confiscated by any lawful authorities nor
lent to anybody;

5. That, I am executing this affidavit to attest the truthfulness of all the foregoing facts
and for whatever legal intent and purpose this may serve.
 IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of June 2019 at
Aparri, Cagayan.

UNIDO SALVADOR

Affiant

SUBSCRIBED AND SWORN to before me this 13th day of June 2019 at Aparri,
Cagayan

ATTY. FRANCISCO U. BULSECO, JR.

Doc. No. 21; Notary Public
Until December 31, 2020
Page No. 5; Roll of Attorney No. 25108
Book No. III; P.T.R. No. 8888627
Issued on January 3, 2019
Series of 2019. Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, LORIELYN A. RACHO, of legal age, single, Filipino citizen and

resident of San Antonio, Aparri, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

6. That I was issued an Automated Teller Machine Card by City

Savings Bank, Aparri Branch and I am a holder and possessor a Pag-
ibig Identification Card issued at Tuguegarao Branch;
7. That, the aforesaid Automated Teller Machine (ATM) Card and
Pag-ibig Identification Card which I put in one of my files were
inadvertently misplaced and consequently lost under circumstances
beyond my control;
8. That, despite diligent efforts on my part to locate and retrieve the
said file including the aforesaid items, the same, however, proved
futile;
9. That, the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
10.That, I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 16 th day of
May 2019 at Aparri, Cagayan.
 LORIELYN A. RACHO
Affiant

SUBSCRIBED AND SWORN to before me this 16th day of May 2019 at

Aparri, Cagayan

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___; Notary Public
Until December 31, 2020
Book No. II;
Roll of Attorney No. 25108
Series of 2019. P.T.R. No. 8888627
Issued on January 3, 2019
Issued at Aparri, Cagayan

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )

AFFIDAVIT OF LOSS

I, FAUSTO P. ANTONIO, of legal age, married, Filipino citizen and

resident of #13 Zuniega St., Gonzaga, Cagayan, after having been duly sworn to in
accordance with law, hereby deposes and says:

1. That I am the holder and possessor of a Professional Driver’s License

issued by the Land Transportation Office (LTO), Tax Identification
Number (TIN) Card, Automated Teller Machine (ATM) issued by the
Land Bank of the Philippines, Voter’s Identification Card and Firearms
License;
2. That the aforesaid items which I put in one of my wallet was
inadvertently misplaced and consequently lost under circumstances
beyond my control;
3. That despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid items, the same, however, proved futile;
4. That the aforesaid items were never confiscated by any lawful
authorities nor lent to anybody;
5. That I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may
serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 18 th day of
January 2019 at Aparri, Cagayan.
 FAUSTO P. ANTONIO
Affiant

SUBSCRIBED AND SWORN to before me this 18th day of January 2019

at Aparri, Cagayan

ATTY. FRANCISCO U. BULSECO,

Doc. No. ____; JR.
Page No. ____; Notary Public
Until December 31, 2020
Book No. I;
REPUBLIC OF THE PHILIPPINES )
Series of 2019.
PROVINCE OF CAGAYAN ) S. S.
MUNICIPALITY OF APARRI )
AFFIDAVIT OF LOSS

I, LIZA B. PESCADOR, of legal age, married, Filipino Citizen and a resident of

Minanga, Aparri, Cagayan, after having been duly sworn to in accordance with law,
hereby deposes and says:

1. That I am a teacher of Minanga Elementary School;

2. That on March 2017 I have loaned to Providers Loan Office and such I
issued a KAYA ATM CARD;
3. That, on December 2021, the aforesaid Atm Card which I put inside my
wallet was missing and consequently lost under circumstance beyond my
control;

4. That, despite diligent efforts on my part to locate and retrieve the said
wallet including the aforesaid Atm Card, the same, however, proved
futile;

5. That, the aforesaid Atm Card were never confiscated by any lawful
authorities nor lent to anybody;
6. That, I am executing this affidavit to attest the truthfulness of all the
foregoing facts and for whatever legal intent and purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 4 th day of January
2022 at Aparri, Cagayan.

LIZA B. PESCADOR
Affiant
PRC No. 0387567

SUBSCRIBED AND SWORN to before me this 4th day of January 2022 at

Aparri, Cagayan.

ATTY. FRANCISCO U. BULSECO,

Doc. No. ___; JR.
Page No. ___;
Book No. XII;
Series of 2022.
 Notary Public
Until December 31, 2022
Roll of Attorney No. 25108
P.T.R. No. 11686327
Issued on January 3, 2022
Issued at Aparri, Cagayan