REPUBLIC OF THE PHILIPPINES)

CITY OF PUERTO PRINCESA )S.S.

AFFIDAVIT
I, ______________________________________________, of legal age, Filipino, and a resident
of_____________________________________________; after having been duly sworn to in accordance
with law, hereby depose and say; that:

1. I am the owner of a Credit Card from the PHILIPPINE NATIONAL BANK (PNB);

2. On______________________________, I received a text message from PNB informing me of

an online purchased made in Amazon at around 4:25 PM, and 2:49 PM for the
amount of___________________________________________________, and
_______________________________________________________respectively;

3. I never made the aforementioned transaction nor was I aware of said

unauthorized purchases ;
4.

5. Since my Credit Card is now compromised, I am authorizing the PNB to conduct

an investigation on the matter;

6. I am executing this Affidavit to attest to the truth of all the foregoing statements,
and to conduct an investigation for the unauthorized transaction, and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 30th day of May 2019 at
Puerto Princesa City.

_____________________________________________
AFFIANT

SUBSCRIBED AND SWORN to before this 30th day of May 2019 at Puerto Princesa
City. The Affiant, personally appearing before me, and her identity is personally known to
me, the former being a long time client of the Notary Public’s law firm.

Doc. No. ______

Page No. ______
Book No. _____
Series of 2019.