REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, GERRY ALMONACID BASILIO, of legal age, Filipino, married and

resident of Block 1 Lot 19, Phase 1, Casimiro Townhomes, Naga Road, Las
Pias City, after having been duly sworn to in accordance with law, hereby
depose and say that:

1. I am a holder and owner of AFP Enlisted Personnel identification

card issued by the Armed Forces of the Philippines, in which, inter alia,
contained the following personal information:

BIRHTDATE : January 12, 1973

SEX : Male
NATIONALITY : Filipino
I.D. NO. : N09-E-5793 issued on 10/12/2009 until 9/29/2012.

2. My said AFP identification card inadvertently lost.

3. Despite of diligent efforts to look for said AFP identification card, all
such efforts proved futile and in vain, thus, I am declaring the loss of my
said AFP identification card.

4. I have never lent or allowed any person to use my said AFP

identification card nor has such AFP id card been confiscated by law
enforcement agencies or the subject of any pending litigation.

5. I am executing this affidavit to attest to the truth of the foregoing

facts for all its legal intents, effects, consequences and purposes including
for the issuance to me of another AFP identification card in lieu of the one
that was lost.

GERRY ALMONACID BASILIO

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this December 10,

2011 at Las Pinas City.

Doc. No. 500

Page No. 101
Book No. 52
Series of 2011