REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF SAN MATEO)S.S.

PROVINCE OF RIZAL )
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AFFIDAVIT OF LOSS

I, ESTER IGNACIO LETIM, of legal age, married, Filipino, and a resident

Blk. 2 Lot 2-K #38 Newtown Ave. Greenland Executive Village, Ampid I, San Mateo,
Rizal, after having sworn to in accordance with law under oath depose and say:

1. That I am an authorized holder of Senior Citizen Identification Card

issued by Office of the Senior Citizens Affairs, San Mateo, Rizal;

2. That sometime in February 12, 2024 when I arrived home I noticed that
said I.D. was missing inside my bag. I reckoned that I might have left
somewhere else

3. That despite diligent effort to locate the said ID, I consider it lost;

4. That I am executing this Affidavit for the purpose of securing a new

Identification Card from the Office of the Senior Citizens Affairs in
replacement of the lost one;

FURTHER AFFIANT SAYETH NONE:

IN WITNESS WHEREOF, I have hereunto signed this instrument this 1 st day of

March, 2024 at San Mateo, Rizal.

ESTER IGNACIO LETIM

Affiant

SUBSCRIBED AND SWORN to before me this 1st day of March, 2024 the
affiant exhibiting to me her National Identification Card with ID No. 4231-0372-0149-
6402 as proof of her identity.

JOSEPH ERIK Y. NEPOMUCENO

Public Attorney I
Pursuant to R.A. 9406