Republic of the Philippines) of

Batangas )s.s.
X X

AFFIDAVIT OF LOSS

I, REX B. MANAL, Filipino, single, of legal age, resident of Brgy. San Pioquinto Malvar,
Batangas, after having been sworn by law hereby depose and state that:

1. I am the owner of a Company ID issued by PRICON and Micro Electronic Inc., in Brgy.
Bulihan, Malvar, Batangas;

2. Sometime around June 1, 2024, in an unexpected situation I missed my ID and, I lost the
above company ID in the area of Sea Oil Gasoline station in Brgy. Poblacion Malvar,
Batangas around 5:30am and also under the following circumstances;

3. Despite diligent efforts exerted, I could not locate or recover the said Company ID, and
to the best of my knowledge, the same is truly lost;

4. The said company ID, has not been confiscated by any officer of the law or the issuing
agency or office due to the violation of any law, statute, order, rule, or regulation;

5. If the lost company ID should hereafter be found or located, I undertake to forward or

surrender the same to the company where I worked for appropriate disposal;

6. I am executing this affidavit to attest to the truth of the foregoing and to request the
issuance of a new company ID to replace the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 04 th of June, 2024, in Malvar,
Batangas, Philippines.

REX B. MANALO
Affiant
Issued ID: National ID
ID No. 8560-1531-4029-8439

SUBSCRIBED AND SWORN to before me on this 04th day of June 2024, in Malvar,
Batangas Philippines.

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