Republic of the Philippines )

City of Manila ) S.S.

AFFIDAVIT OF LOSS
I, MARIA GERIELYN BARIS SERRANO, of legal age, single with residence and
postal address at 1312 Casañas St., Sampaloc, Manila, after being sworn to in
accordance with law, depose and say that:

1) I am an employee of United Brilliant Administration and Management Inc.

(UBAMI) with office address at 1588 M.H. del Pilar Street, Manila;
2) As such, I was provided by our employer with several Identification Card.
3) I was assigned at our Cagayan Office on the month of March. In my everyday
way to and from the office my wallet is tucked at the back of my pants;
4) However, last May 29, 2020, after arriving from Office, I was surprised to have
known that my wallet containing my Identification Card, was already missing as it
might have accidentally fell-off from the back pocket of my pants then while on
my way to office during that day;
5) Diligent efforts have already been exerted to locate and or retrieve my wallet
along with my ID, but all turned out futile;
6) I have request for the re-issuance of the new IDENTIFICATION CARD in
furtherance of my personal transactions and such other business transactions
which may require the presentation of those aforementioned missing ID;
7) This affidavit is being executed to attest to the veracity of the foregoing facts and
for whatever legal purpose it may serve.

AFFIANT FURTHER SAYETH NAUGHT.

June 14, 2020, Manila City

MARIA GERIELYN B. SERRANO

Affiant

SUBSCRIBED AND SWORN to me before this ____ day of ______________ at

___________, Philippines, affiant exhibiting to me his CTC # _______________, issued
at Manila City, on ________________.

NOTARY PUBLIC

Doc. No.
Page No.
Book No.
Series of 2020