REPUBLIC OF THE PHILIPPINES)

PROVINCE OF NUEVA ECIJA )

IN THE CITY OF CABANATUAN ) S.C.
x------------------------x

AFFIDAVIT OF LOSS
I, EMMA P. CASTILLO, of legal age, Filipino Citizen, married, and a resident
of Murcon, Llanera, Nueva Ecija, after having been sworn to in accordance with
law, do hereby depose and state:

1. That I am a holder/possessor of the following Identification Card and

ATM Card:
a) Pantawid Pamilyang Pilipino Program ID (4Ps)
b) 4Ps ATM Card (Land Bank)
c) Voter’s ID

2. That on October5, 2018, I got lost my wallet containing the above-

mentioned Identification Card and ATM Card;

3. That I exerted utmost efforts to locate the same but all remained in
vain and futile;

4. That this Affidavit has been executed to attest to the truth of all the
foregoing facts and for whatever legal intents and purposes this may
serve.

IN WITNESS WHEREOF, I have hereunto affixed my hand this 16th day of

October, 2018, hereat Cabanatuan City, Nueva Ecija.

EMMA P. CASTILLO
Affiant

SUBSCRIBED AND SWORN to before me, this 16th day of October, 2018,
hereat Cabanatuan City, Nueva Ecija.

Doc. No. 78;

Page No. 17;
Book No. II;
Series of 2018.