REPUBLIC OF THE PHILIPPINES)

CITY OF NAVOTAS ) SS.

AFFIDAVIT OF LOSS

I, CRISLAND RAMOS MANINGAS, of legal age, Married, Filipino, and a

resident of Block 30 Lot 81 Phase 2 Area 1, Dagat-Dagatan, Navotas City, after having
been sworn in accordance with law do hereby depose and state, That:

1. I am a holder of a Philippine Passport with Passport No. EB0140892 issued

by the Department of Foreign Affairs (DFA) on April 24, 2010, with date of
expiration on April 23, 2015.
2. Sometime this month of September 2018, I was surprised to find the said
passport missing from my personal belongings in my house.
3. I exerted diligent effort to locate and find my said passport but still the same
was to no avail.
4. The said loss was not due to negligence but due to circumstance beyond my
control, for I have kept the subject passport secured in a cabinet.
5. That I am executing this affidavit to attest to the truthfulness of the foregoing
facts and statement for the purpose of applying for a new Philippine Passport
with the Department of Foreign Affairs and for whatever legal purpose it may
serve.

AFFIANT SAYETH NAUGTH.

IN WITNESS WHEREOF, I have hereunto set my hand this ____day of

________________ 2019 at the City of Navotas.

CRISLAND RAMOS MANINGAS

Affiant

Subscribed and sworn to before me, this _____day of _________________ 2019,

after exhibiting to me her Voter’s ID issued by the COMELEC of Navotas City with ID
No.________________________ issued on ______________________ at Navotas City.

Doc No._________,
Page No. ________,
Book No. ________,
S e r i e s of 2 0 1 9.