(Republic of the Philippines

City of Cagayan de Oro) S.S.

AFFIDAVIT OF LOSS

I, MARKY LLENAREZ, Filipino, married, of legal age, and a resident of Cagayan de

Oro City, Misamis Oriental, Philippines. After having duly sworn to in accordance
with law, hereby depose and say that:

1. While I was on my way to work, I accidentally dropped my wallet where I

placed my Landbank ATM Card and only found out that my wallet was gone
after arriving at my workplace;

3. I exerted all efforts to locate the said wallet with my Landbank ATM card but I
could no longer recover it anymore and is therefore considered lost for all
legal purposes;

4. I am executing this affidavit to attest to the truth and veracity of the foregoing
statements, and for all LEGAL INTENTS and PURPOSES it may serve best,
especially as a requirement for the replacement of my lost Landbank ATM
card at LANDBANK;

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

_________ 2024 in the City of Cagayan de Oro, Philippines.

MARKY LLENAREZ
Affiant

SUBSCRIBED AND SWORN to before me this ____day of _________ 2024,

in the City of Cagayan de Oro, Philippines, affiant having exhibited to me his LTO
I.D. with number:

Doc. No. _________;

Page No._________;
Book No._________;
Series of 2024