0Republic of the Philippines )

Province of Cavite )S.S.

Trece Martires )

AFFIDAVIT OF LOSS

I, ALEX ANI GABARDA, Filipino, of legal age, married, and a resident of Blk 89 Lot 13
Golden Horizon Subdivision Phase 2, Baranggay Hugo Perez, Trece Martires City, Cavite,
Philippines, having been duly sworn in accordance with law, hereby depose and state:

1. That I am the holder of Social Security System Identification with Number 05-112585-3
Philhealth Identification, loyalty card, Pag ibig-IBIG Identification, Company
Identification, National Identification, the details I could no longer recall;

2. Unfortunately, on December 01, 2023, the above Social Security System Identification
with Number 05-112585-3 Philhealth Identification, loyalty card, Pag ibig-IBIG
Identification, Company Identification, National Identification well fell from my
possession when I was on Golden Horizon Subdivision Phase 2, Baranggay Hugo Perez,
Trece Martires City, Cavite, Philippines ;

3. That despite diligent search and efforts to locate the said Golden Horizon Subdivision
Phase 2, Baranggay Hugo Perez, Trece Martires City, Cavite, Philippines, I could not find
the same such that I now believe that it is now lost beyond recovery;

4. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and
to support the application for the issuance of new one in lieu of the one which was lost,
moreover serve all legal intents.

.
IN WITNESS WHEREOF, I have hereunto set my hand this 12th day of February 2024 at Trece
Martires City, Cavite, Philippines.

ALEX ANI GABARDA

Affiant

SUBSCRIBED AND SWORN TO before me, a Notary Public in and for the City of Trece
Martires, this 12th day of February 2024, affiant ALEX ANI GABARDA, whom I identified through
the following competent evidence of identity: Philippine Passport bearing the number
P4879421B personally signed the foregoing instrument before me and avowed under penalty of
law to the whole truth of the contents of said instrument.

Doc. No. : 230

Page No. : 46 ATTY. FE B. AÑONUEVO
NOTARY PUBLIC UNTIL 31 DECEMBER 2024
Book No. : 161 Notarial Commission No. TMNP 018-22
For the Cities of Trece Martirez, Gen.Trias &
Series : 2024 Mun. of Tanza, Province of Cavite
ROLL OF ATTORNEY No. 35746
PTR No. CAV 8301296 / 02 January 2024, TMC Cavite
7th MCLE Exemption No. 0005165 Until April 4, 2025
Unit 8C, Digma Commercial Center, Brgy. Luciano,
Trece Martires City, Cavite