REPUBLIC OF THE PHILIPPINES)

CITY OF ANTIPOLO ) S.S.

x----------------------------------x

AFFIDAVIT OF LOSS

I, MARICRIS T. BASTO of legal age, Filipino, single and a resident of

Unit 7 Sitio Sto. Nino Pagrai Mayamot Antipolo City, after having been
duly sworn to in accordance with law, depose and state THAT:

1. That I am a holder of EAST WEST BANKING CORPORATION ATM

Card;

2. That on October 18, 2019, the said Identification Card was lost
and got misplaced;

3. Despite diligent search and efforts to locate the said

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

4. As such, I am executing this affidavit to attest to the foregoing

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

IN WITNESS WHEREOF, I have hereunto set my hand

this_______________ in Antipolo City, Philippines.

JOEL SALAS MANTALABA

VOTER’S ID NO. 4524-0311A-I0175JSM10000-4

SUBCRIBED AND SWORN TO before me this _________________ in

_________________, Philippines, affiant exhibiting to me his valid proof of
identification .

Doc. No. _____;

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