Republic of the Philippines )

City of Tacloban ) S.S.

x—————————————x

AFFIDAVIT OF DESTRUCTION/MUTILATION

I, GRETCHEN CRUZ-ABELLANA, of legal age, married,

Filipino citizen, and presently residing at Block 29, Lot 1, Phase 2B,
V and G Subdivision, Tacloban City, after having been duly sworn
to in accordance with law, do hereby depose and say:

1. That I am a holder of Philippine Passport No.EC5961006 issued

on November 12, 2015 by the Philippine Consulate General in
Dubai;

2. That the said passport has become damaged/mutilated for the

reason that it got inadvertently wet inside my bag through no fault
or negligence on my part;

3. That the damage on the said passport has rendered it unusable

for travel purposes and therefore I request the Department of
Foreign Affairs Regional Office 8 to issue a new passport in my
favor;

4. That I attest to the veracity of the foregoing information.

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

day of _______ 2017 at Tacloban City, Philippines.

GRETCHEN CRUZ-ABELLANA
Affiant

SUBSCRIBED AND SWORN to before me this ____ day

of ______ 2017 in Tacloban City, Philippines, affiant exhibiting to
me her competent evidence of identity by way of her Driver’s
License issued by the Land Transportation Office in Naval, Biliran
on December 5, 2016.

Doc No. : _____

Page No.: ______
Book No.: ______
Series of 2017 Notary Public