REPUBLIC OF THE PHILIPPINES

CITY OF MUNTINLUPA SS
x _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _x

AFFIDAVIT OF LOSS
OF PASSPORT

I, JON ANGELO GUEVARRA TADEO, of legal age, Filipino, single

and a resident of Blk. 18 & 19 Firetree St. Waterwood Park, Baliuag, Bulacan,
after having been duly sworn to in accordance with law, hereby depose and
state THAT:

1) Valid until last June of 2017 was my Philippine Passport issued

by the Department of Foreign Affairs, however, I can no longer
recall the Passport Number of the said Passport;

2) Sometime in the year 2016, I gave my Philippine Passport to my

former employer.

3) Only a year after my resignation I tried retrieving my passport;

4) Unfortunately my former employer misplaced my documents

including my Philippine Passport;

5) Despite diligent follow-ups and efforts to locate the said

passport, I could not find the same such that I now believe that it
is now lost beyond recovery;

6) I am executing this Affidavit of Loss to attest to the truth of the

foregoing and to support the application for the issuance of a
new one in lieu of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this October

21, 2019, at Muntinlupa City, Philippines.

JON ANGELO G. TADEO

Affiant

SUBSCRIBED AND SWORN TO before me this 21st of October 2019

in Muntinlupa City, Philippines, affiant exhibiting to me his valid proof of
identification.

Doc. No. __________;

Page No.__________;
Book No.__________;
Series of 2019.