Republic of the Philippines )

Province of Zamboanga del Norte) S.S.

City of Dipolog )

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, MARY JUNE SY-PAUNDOG of legal age, Filipino, married, and a resident of

Block 2, Lot 20, Rufina Heights, Dicayas, Dipolog City, after having been sworn in
accordance with law, hereby deposes and states the following:

1. I am holder/owner/ or possessor of the following employee identification card

of Zamboanga del Norte Electric Cooperative Inc.,

2. I have recently discovered the said ID is irretrievably lost and can no longer be
found despite diligent efforts to locate the same;

3. I execute this affidavit to attest to the truth of the foregoing.

Signed on the date and at the place indicated below.

MARY JUNE V. SY-PAUNDOG

ID: Pag-Ibig ID
issued on: 03-22-2012
at: Quezon City, Philippines

SUBSCRIBED and SWORN TO before me on the date and at the place indicated
below. The affiant exhibited to me his competent evidence of identity as indicated above.

Signed this ______________at ________________, ______________________,

Philippines.

WITNESS MY HAND AND SEAL.

Notary Public

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