REPUBLIC OF THE PHILIPPINES

Province of Guimaras )S.S

AFFIDAVIT OF LOSS
I, KARL F. ARILAS, of legal age, married, American, and a temporary resident of
Barangay San Nicolas, Buenavista, Guimaras, Philippines, after having been duly sworn to in
accordance with law, hereby voluntarily depose and state;

1. That I am the holder or owner of the following lost identification Cards issued in the
United States of America (USA):

International Driver’s License

2 Northwest Debit Cards
Social Security Number Card
College School ID

2. That despite diligent search and efforts to locate the said identification cards the same
could no longer be found such that I now believe that it is now lost beyond my recovery;

3. That I am executing this Affidavit to attest to the truth of the foregoing statements and for
all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I hereunto affixed my signature this 19th day of November

2019, at the Province of Guimaras, Philippines.

KARL F. ARILAS
Affiant

SUBSCRIBED AND TO SWORN to before me, a Notary Public for the Province of
Guimaras this 19th day of November, 2019 at San Miguel, Jordan, Guimaras.

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