REPUBLIC OF THE PHILIPPINES)

_________________________ ) S.S

AFFIDAVIT OF LOSS
I, ARISTOTLE LOPEZ CALINAO, Filipino, of legal age, presently residing at
403-D Dr. Sixto Antonio Avenue, Maybunga Pasig City, after having been sworn to in
accordance with law hereby depose and state:
1. That the Social Security System issued to me a Digitized SSS ID with SSS No.
33-8021645-6
2. That sometime in December of year 2014, I was looking for my SSS ID but to my
surprise, said SSS ID could not be found;
3. That I took pains to look for said SSS ID, but to no avail;
4. That I am executing this affidavit to attest to the truth of the foregoing and to
request from the Social Security System, a new SSS ID.

IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day of March 2015
at Taguig City.

ARISTOTLE L. CALINAO
Affiant
SUBSCRIBED AND SWORN to before me this
day of
, 2015 in the city of
, affiant
exhibiting to me his Tax Identification Number 232-429-637-000, issued at BIR Taguig Branch, on
September 14, 2014.

NOTARY PUBLIC
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